U.S. GOVERNMENT PRINTING OFFICE

65–696 CC WASHINGTON : 2000

REDUCING NONMARITAL BIRTHS

HEARING

BEFORE THE

SUBCOMMITTEE ON HUMAN RESOURCES

OF THE

COMMITTEE ON WAYS AND MEANS

HOUSE OF REPRESENTATIVES

ONE HUNDRED SIXTH CONGRESS

FIRST SESSION

JUNE 29, 1999

Serial 106–35

Printed for the use of the Committee on Ways and Means

(

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Superintendent of Documents, Congressional Sales Office, Washington, DC 20402

(II)

COMMITTEE ON WAYS AND MEANS

BILL ARCHER, Texas, Chairman

PHILIP M. CRANE, Illinois

BILL THOMAS, California

E. CLAY SHAW, JR., Florida

NANCY L. JOHNSON, Connecticut

AMO HOUGHTON, New York

WALLY HERGER, California

JIM MCCRERY, Louisiana

DAVE CAMP, Michigan

JIM RAMSTAD, Minnesota

JIM NUSSLE, Iowa

SAM JOHNSON, Texas

JENNIFER DUNN, Washington

MAC COLLINS, Georgia

ROB PORTMAN, Ohio

PHILIP S. ENGLISH, Pennsylvania

WES WATKINS, Oklahoma

J.D. HAYWORTH, Arizona

JERRY WELLER, Illinois

KENNY HULSHOF, Missouri

SCOTT MCINNIS, Colorado

RON LEWIS, Kentucky

MARK FOLEY, Florida

CHARLES B. RANGEL, New York

FORTNEY PETE STARK, California

ROBERT T. MATSUI, California

WILLIAM J. COYNE, Pennsylvania

SANDER M. LEVIN, Michigan

BENJAMIN L. CARDIN, Maryland

JIM MCDERMOTT, Washington

GERALD D. KLECZKA, Wisconsin

JOHN LEWIS, Georgia

RICHARD E. NEAL, Massachusetts

MICHAEL R. MCNULTY, New York

WILLIAM J. JEFFERSON, Louisiana

JOHN S. TANNER, Tennessee

XAVIER BECERRA, California

KAREN L. THURMAN, Florida

LLOYD DOGGETT, Texas

A.L. SINGLETON, Chief of Staff

JANICE MAYS, Minority Chief Counsel

SUBCOMMITTEE ON HUMAN RESOURCES

NANCY L. JOHNSON, Connecticut, Chairman

PHILIP S. ENGLISH, Pennsylvania

WES WATKINS, Oklahoma

RON LEWIS, Kentucky

MARK FOLEY, Florida

SCOTT MCINNIS, Colorado

JIM MCCRERY, Louisiana

DAVE CAMP, Michigan

BENJAMIN L. CARDIN, Maryland

FORTNEY PETE STARK, California

ROBERT T. MATSUI, California

WILLIAM J. COYNE, Pennsylvania

WILLIAM J. JEFFERSON, Louisiana

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records

of the Committee on Ways and Means are also published in electronic form. The printed

hearing record remains the official version. Because electronic submissions are used to

prepare both printed and electronic versions of the hearing record, the process of converting

between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process

is further refined.

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C O N T E N T S

Page

Advisory of June 22, 1999 announcing the hearing .............................................. 2

WITNESSES

U.S. Department of Health and Human Services, Stephanie Ventura, Senior

Researcher, National Center for Health Statistics, Centers for Disease Control and Prevention .............................................................................................. 14

Alan Guttmacher Institute, Cory L. Richards ....................................................... 80

American Public Human Services Association, John Sciamanna ........................ 108

Mathematica Policy Research, Inc., University of Pennsylvania, Rebecca A.

Maynard ................................................................................................................ 92

National Campaign to Prevent Teen Pregnancy, Brenda Rhodes Miller ............ 96

Nelson A. Rockefeller Institute of Government, Richard P. Nathan ................... 37

New Jersey Department of Human Services, Edward Tetelman ........................ 104

Preserving Family Well-Being Foundation, Pat Funderburk Ware .................... 78

Rector, Robert, Heritage Foundation ..................................................................... 45

Sawhill, Isabel V., Brookings Institution, and National Campaign to Prevent

Teen Pregnancy .................................................................................................... 68

Westat, Nicholas Zill ............................................................................................... 25

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REDUCING NONMARITAL BIRTHS

TUESDAY, JUNE 29, 1999

HOUSE OF REPRESENTATIVES,

COMMITTEE ON WAYS AND MEANS,

SUBCOMMITTEE ON HUMAN RESOURCES,

Washington, DC.

The Subcommittee met, pursuant to notice, at 10:05 a.m., in

room B–318, Rayburn Office Building, Hon. Nancy L. Johnson

(Chairman of the Subcommittee), presiding.

[The advisory announcing the hearing follows:]

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ADVISORY

FROM THE COMMITTEE ON WAYS AND MEANS

SUBCOMMITTEE ON HUMAN RESOURCES

FOR IMMEDIATE RELEASE CONTACT: (202) 225–1025

June 22, 1999

No. HR–8

Johnson Announces Hearing

on Reducing Nonmarital Births

Congresswoman Nancy L. Johnson (R–CT), Chairman, Subcommittee on Human

Resources of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on reducing nonmarital births. The hearing will take

place on Tuesday, June 29, 1999, in room B–318 of the Rayburn House Office Building, beginning at 10:a.m.

Oral testimony at this hearing will be from invited witnesses only. Witnesses will

include officials from Congressional agencies, program administrators, researchers,

and advocates. However, any individual or organization not scheduled for an oral

appearance may submit a written statement for consideration by the Committee and

for inclusion in the printed record of the hearing.

BACKGROUND:

For several generations, both the number and percentage of American children

born outside marriage has been increasing. Simultaneously, social science evidence

has been accumulating to demonstrate that nonmarital births are bad for the children involved, their parents, and society. Among other findings, children born outside marriage are more likely to be poor, perform poorly in school, drop out of

school, have criminal records, and have nonmarital births themselves. Similarly,

mothers giving birth outside marriage are more likely to be poor, go on welfare, become dependent on welfare, and be unemployed. However, historical trends also

suggest that the Nation is making some progress in its fight to stanch the increase

in babies born outside marriage.

The 1996 welfare reform law (P.L. 104–193) contained numerous provisions designed to reduce nonmarital births. These included funds for abstinence education

programs, strong paternity establishment requirements, a requirement that teen

mothers live at home or with a responsible adult, a requirement that teen mothers

stay in school, and a cash bonus for States that decrease their nonmarital birth rate

while decreasing their abortion rate.

In announcing the hearing, Chairman Johnson stated: ‘‘Along with the related

problem of declining marriage rates among low-income Americans, the increase in

nonmarital births is the nation’s leading social problem. We have found that the nation’s shocking level of births outside marriage is correlated with almost all our

other social ills. Now, for the first time in several generations, we seem to actually

be making progress in reducing the rate of teen births outside marriage and at least

stopping the increase in the ratio of all American births that occur outside marriage.

We are holding this hearing to find out whether any of the policies we enacted in

1996 are having an impact on the level of nonmarital births and to search for additional steps we can take to encourage young people to defer childbearing until marriage.’’

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FOCUS OF THE HEARING:

The hearing will focus on four issues. First, historical trends in both the illegitimacy ratio and the rate of nonmarital births will be reviewed. Second, the numerous policies included in the 1996 welfare reform law to reduce nonmarital births will

be summarized and their impact on historical trends in nonmarital births assessed.

Further, the hearing will assess the actions being taken by State and local agencies

to implement the Federal policies on nonmarital births as well as additional policies

developed at the State and local level. Third, the hearing will review whether other

societal trends, such as the increased fear of sexually transmitted diseases and the

increased use of long-term contraceptives, have had an impact on nonmarital birth

rates. Fourth, the hearing will examine new policies that should be considered to

ensure that the Nation continues to make progress in reducing the number of children born outside marriage.

DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:

Any person or organization wishing to submit a written statement for the printed

record of the hearing should submit six (6) single-spaced copies of their statement,

along with an IBM compatible 3.5-inch diskette in WordPerfect 5.1 format, with

their name, address, and hearing date noted on a label, by the close of business,

Tuesday, July 13, 1997, to A.L. Singleton, Chief of Staff, Committee on Ways and

Means, U.S. House of Representatives, 1102 Longworth House Office Building,

Washington, D.C. 20515. If those filing written statements wish to have their statements distributed to the press and interested public at the hearing, they may deliver 200 additional copies for this purpose to the Subcommittee on Human Resources office, room B–317 Rayburn House Office Building, by the close of business

the day before the hearing.

FORMATTING REQUIREMENTS:

Each statement presented for printing to the Committee by a witness, any written statement

or exhibit submitted for the printed record or any written comments in response to a request

for written comments must conform to the guidelines listed below. Any statement or exhibit not

in compliance with these guidelines will not be printed, but will be maintained in the Committee

files for review and use by the Committee.

1. All statements and any accompanying exhibits for printing must be submitted on an IBM

compatible 3.5-inch diskette in WordPerfect 5.1 format, typed in single space and may not exceed a total of 10 pages including attachments. Witnesses are advised that the Committee

will rely on electronic submissions for printing the official hearing record.

2. Copies of whole documents submitted as exhibit material will not be accepted for printing.

Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material

not meeting these specifications will be maintained in the Committee files for review and use

by the Committee.

3. A witness appearing at a public hearing, or submitting a statement for the record of a public hearing, or submitting written comments in response to a published request for comments

by the Committee, must include on his statement or submission a list of all clients, persons,

or organizations on whose behalf the witness appears.

4. A supplemental sheet must accompany each statement listing the name, address, telephone

and fax numbers where the witness or the designated representative may be reached. This supplemental sheet will not be included in the printed record.

The above restrictions and limitations apply only to material being submitted for printing.

Statements and exhibits or supplementary material submitted solely for distribution to the

Members, the press, and the public during the course of a public hearing may be submitted in

other forms.

Note: All Committee advisories and news releases are available on the World

Wide Web at ‘HTTP://WWW.HOUSE.GOV/WAYSlMEANS/’.

The Committee seeks to make its facilities accessible to persons with disabilities.

If you are in need of special accommodations, please call 202–225–1721 or 202–226–

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Questions with regard to special accommodation needs in general (including availVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00007 Fmt 6633 Sfmt 6621 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
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ability of Committee materials in alternative formats) may be directed to the Comeveryone.

mittee as noted above.

Chairman JOHNSON of Connecticut [presiding]. Good morning,

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Today, we move forward in the series of hearings we have

planned to methodically and comprehensively fulfill our obligation

to oversee the implementation and performance of the welfare reform legislation of 1996.

This is a hearing I have been looking forward to because I was

not one of those who believed that funding abstinence programs

could have much effect on nonmarital birthrates. I believed then

and am more convinced than ever now that welfare reform will

have an effect on the number of children born out of wedlock, and

I think this is important because of the enormous economic and

emotional support children need in today’s world. But this hearing

will give us the first good information on the effect of the provisions in the 1996 Welfare Reform bill and the opportunity we may

have to discourage nonmarital births.

There is overwhelming data that nonmarital births is one of the

Nation’s two or three greatest social problems. School failure,

school dropout, welfare use, poor jobs, crime and delinquency and

a host of other problems do unfortunately correlate with being born

to unmarried mothers, that is, without the full support economically and emotionally of two adults.

There also seems to be considerable agreement that if we could

substantially reduce the number of nonmarital births, we would

improve the lives of millions of adults and children and reduce the

severity of some of the social problems just listed.

As we will see in the presentations by Dr. Ventura and several

of the witnesses, for the first time since the early 1960s, today we

actually have good news about trends in nonmarital births. The

teen birthrate has been declining since the early 1990s, and the

overall ratio of nonmarital births has been more or less stable for

3 years.

These are welcome and hopeful developments, but do these

trends signal a true change in nonmarital births or simply a pause

in their relentless increase? The purpose of today’s hearing is to review these questions and discuss provisions we put in the 1996

Welfare Reform bill, designed to reduce nonmarital births.

I am pleased that the Congressional Research Service has published two concise and exceptionally useful papers on nonmarital

births. One of these summarizes the provisions of the 1996 Welfare

Reform law designed to reduce these births, and the other is a brief

overview of some of the major issues. We have placed copies of both

papers in the Members’ folders and copies are available on the

table.

[The information follows:]

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Chairman JOHNSON of Connecticut. It is my intent to try to determine the effectiveness of the 1996 provisions and gain better insight into how this subcommittee can better support families and

discourage nonmarital births.

What effect did the changes in the law have? What role—the

very public debate on this issue during the welfare reform debate,

what role did that public debate play? That was the first public discussion of the discouraging data associated with these kids’s futures, as well as with the future of their moms and dads. I am anxious to hear what our distinguished witnesses have to say about

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these vital issues and especially about whether additional policy

changes could help.

[The opening statement follows:]

Statement of Chairman Nancy L. Johnson, a Representative in Congress

from the State of Connecticut

Today we move forward in the series of hearings we have planned to methodically

and comprehensively fulfill our obligation to oversee the implementation and performance of the welfare reform this Congress passed in 1996. This is a hearing I

have been looking forward to because I was not one of those who believed that funding abstinence programs could have much effect on nonmarital birthrates. I believed

then and am more convinced than ever now that welfare reform will reduce the

number of children born out of wedlock and I think that is important because of

the enormous economic and emotional support children need in today’s world. This

hearing will give us the first good information on this important matter for kids and

families.

There is now overwhelming data that nonmarital births is one of our nation’s two

or three greatest social problems. School failure, school dropout, welfare use, poor

jobs, crime and delinquency, and a host of other problems do, unfortunately, correlate with being born to unmarried mothers, that is without the full support—both

economic and emotional—of two adults. There also seems to be considerable agreement that if we could substantially reduce the number of nonmarital births, we

would improve the lives of millions of adults and children and reduce the social

problems just listed.

As we will see in the presentations by Dr. Ventura and several other witnesses,

for the first time since the early 1960s, today we actually have good news about

trends in nonmarital births. The teen birthrate has been declining since the early

1990s and the overall ratio of nonmarital births has been more or less stable for

3 years. These are welcome and hopeful developments. But do these trends signal

a true change in nomarital births or simply a pause in their relentless increase?

The purpose of today’s hearing is to review these questions and to discuss provisions we put in the 1996 Welfare Reform bill designed to reduce nonmarital births.

I am very pleased to announce that the Congressional Research Service has published two concise and exceptionally useful papers on nonmarital births. One of

these summarizes the provisions of the 1996 welfare reform law designed to reduce

these births; the other is a brief overview of some of the major issues. We have

placed copies of both papers in the members folders and copies are available on the

table.

It is my intent to try to determine the effectiveness of the 1996 provisions and

gain better insight into how this Subcommittee can better support families and discourage nonmarital births. What role did the changes in the law play? What role

did the very public debate on this issue during the welfare reform debate play? That

was the first public discussion of the discouraging data associated with these kids’

futures, as well as that of their moms and dads.

I’m anxious to hear what our distinguished witnesses have to say about these

vital issues—and especially about whether additional policies could be helpful.

And I would like to yield to my colleague, Mr. Cardin.

Mr. CARDIN. Well, thank you, Madam Chair, and let me thank

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you for holding these hearings. I, too, look forward to listening to

the experts on the panels that we have today.

Birth to teenage mothers has been declining for nearly a decade,

and that is certainly good news. I, for one, have always felt that

we should make a higher national priority the problems of teenage

moms. The question before this panel is what government policies

or societal changes promote this reduction and what we can do to

maintain the progress that we have already made in this area.

I am one of the Members who voted the 1996 Welfare Reform

law, and I hope that the measures that emphasize parental responsibility would have a positive impact on reducing the number of

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teenage pregnancies, parental responsibility for both the mother

and the father. However, since the reductions in teenage birthrates

has now been going on for about 10 years, we may need to look a

little further for explanation as to why we have been making some

progress in this area.

This recent progress should not deter us from working to further

reduce the number of children having children, especially since our

Nation’s teenage pregnancy rate is still much higher than nearly

every other industrial nation of the world. However, there may be

some disagreement about how to pursue this goal. For example,

Governor George W. Bush last week, reportedly suggested that

teaching abstinence and safe sex at the same time sends, ‘‘a contradictory message.’’

I worry this position could mean less information and advice on

contraception for young women. It is one thing to say that abstinence should be our first message to young people, but saying that

it should be our only message could take us backwards, not forwards, in our effort to reduce teenage pregnancies. Furthermore, I

don’t know how one can oppose a woman’s right of choice and at

the same time also oppose providing her access to information that

might prevent a pregnancy.

In general, I believe our efforts to highlight the merits of waiting

to have sex does not require us to deprive teenagers of information

about contraception. After all, there is no evidence to suggest that

teaching teenagers about safe sex increases their sexual activity.

Madam Chair, as we begin these hearings today on this subject,

I look forward to our experts helping us as we try to develop the

right policies for our Nation to reduce teenage pregnancy.

Thank you very much.

Chairman JOHNSON of Connecticut. I thank you for your opening

comments.

Now, we will hear from the first panel, Stephanie Ventura of the

National Center for Health Statistics, Centers for Disease Control

and Prevention, and Nicholas Zill, the vice president and director

of Child and Family Study Area, Westat, Inc., from Rockville. Come

join us.

Ms. Ventura, if you will begin. We are very pleased to have your

testimony from the Centers for Disease Control.

STATEMENT OF STEPHANIE VENTURA, SENIOR RESEARCHER,

NATIONAL CENTER FOR HEALTH STATISTICS, CENTERS FOR

DISEASE CONTROL AND PREVENTION, U.S. DEPARTMENT OF

HEALTH AND HUMAN SERVICES

Ms. VENTURA. Madam Chair and Members of the Subcommittee,

I am Stephanie Ventura, a Senior Researcher at the National Center for Health Statistics, an agency within the Centers for Disease

Control and Prevention. Thank you for inviting me here today to

speak with you about trends in births to unmarried women. The

data I will draw on are from the National Vital Statistics System,

one of more than a dozen data systems that the CDC/NCHS operates to allow us to profile the health of Americans.

By working with State health departments, we obtain data recorded on birth certificates, which include an item on marital status, allowing us to monitor trends in nonmarital births. At NCHS,

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I have worked with the data on nonmarital births for over 30

years.

I will be presenting both broad trends and some illustrative details on nonmarital births. Additional information is included in my

formal testimony. Much of this detail is important to grasping what

has proven to be a complex social and health issue. As you sort

through all of the specifics, however, I want to make sure that I

convey these four important points.

No. 1, nonmarital births skyrocketed from 1940 to 1990, but the

trends have stabilized in the 1990s, with a decline in the nonmarital birthrate since 1994.

No. 2, teens are not the only women having nonmarital births.

In fact, two-thirds of nonmarital births are to women 20 and older.

No. 3, teen birthrates have declined considerably since 1991 with

declines in all States and in all racial and ethnic groups.

And No. 4, nonmarital birthrates and teen birthrates have fallen

for all population groups, but most sharply for black women.

Let’s look first at the long-term historical trends in nonmarital

births, using these three key measures as shown in the first chart.

These are, No. 1, the birthrate for unmarried women; No. 2, the

number of births to unmarried women; and No. 3, the percent of

all births that are to unmarried women.

No matter how you look at the statistics, nonmarital childbearing

rose dramatically during the half century from 1940 to 1990. The

birthrate for unmarried women, which describes the proportion of

unmarried women who give birth, increased more than sixfold

overall, with increases in all age groups over this period as shown

in the second chart. The rising number of nonmarital births was

due in large part to the increased birthrates for unmarried women

and the steep increases in the number of unmarried women in the

childbearing ages.

The percent of all births that are to unmarried women rose sevenfold. Because of increases in birthrates for unmarried women

and in the number of unmarried women, as I just described, and

the 40 percent drop in birthrates for married women from the

1960s to the late 1980s. The percent of births to unmarried women

increased substantially in all age groups as shown in this next

chart.

In contrast to previous decades, during the 1990s, nonmarital

childbearing has stopped rising and even declined in some age and

race groups. The birthrate has declined since 1994. The total number of nonmarital births has stabilized in the last several years,

and since 1994, the proportion of births to unmarried women has

been unchanged at 32 percent.

Birthrates for unmarried black women have historically been

higher than for unmarried white women, but the disparity has narrowed in recent years. In the 1990s, the rate for non-Hispanic

white women has declined 5 percent, while the rate for black

women fell 19 percent. The rate for unmarried Hispanic women,

which is now the highest of any group, has declined 10 percent.

Let’s look now at teen births. Although teen birth and nonmarital birth patterns are often considered interchangeable, these rates

are not the same. The birthrate for teens aged 15 to 19 dropped

by 16 percent between 1991 and 1997, and it has continued to

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decline through June 1998. Of particular note, the birthrate for second births to teens who have had a first birth has dropped by 21

percent since 1991, as shown in this next chart.

Despite the declines in teen birthrates, most births that occur to

teenagers are to unmarried teenagers. Birthrates for unmarried

teens have declined steadily since 1994, halting steep increases

which began in the mid-1970s. Rates fell for all unmarried teenagers, but again, with the largest decline for black teens.

What are some of the facts behind these recent declines? Data

from three HHS-operated or -sponsored surveys show that the proportion of teenagers who are sexually experienced has stabilized

and even declined in the 1990s. In addition, teenagers are now

more likely to use contraceptives at first intercourse, especially

condoms. About 12 percent of all teenagers using contraception and

25 percent of black teenagers are using long-lasting hormonal

methods, including injectable and implant contraceptives. These

changes in contraceptive use are also found for older women.

In summary, I hope that my testimony has reinforced the four

major points I made when I began.

Thank you for the opportunity to present this data. I would be

pleased to answer any questions you may have.

Chairman JOHNSON of Connecticut. Thank you very much, Ms.

Ventura.

[The prepared statement follows:]

Statement of Stephanie Ventura, National Center for Health Statistics, Centers for Disease Control, U.S. Department of Health and Human Services

Madam Chairman and Members of the Subcommittee, I am Stephanie Ventura,

a senior researcher at the National Center for Health Statistics (NCHS), an agency

within the Centers for Disease Control and Prevention (CDC). Thank you for inviting me to speak with you today about the trends and variations in births to unmarried women. The data I will draw on are from the National Vital Statistics System,

one of more than a dozen data systems that the CDC/NCHS maintains that allow

us to profile the health and health care experiences of Americans. At NCHS, I have

worked with the data on nonmarital births for over thirty years.

CDC/NCHS is the Nation’s principal health statistics agency. In addition to the

vital statistics system, we obtain our information through ongoing and special studies, including surveys where we interview a representative sample of Americans

about their health, surveys where we conduct direct physical examinations, and surveys using hospital data and data from other providers of care. These data systems

provide information on a broad range of health and health-related topics, ranging

from birth to death and covering such topics as teen pregnancy, blood lead levels

in children, incidence of overweight, cholesterol levels, immunizations, health insurance and access to care, the use of surgical procedures, and life expectancy. Data

from CDC/NCHS are among the most fundamental measures supporting health policy decisions, public health practice, and research.

Today I will be talking with you about statistics from our National Vital Statistics

System. By working with State health departments, we obtain data recorded on

birth certificates. These certificates, initially filed as part of the vital registration

process mandated in each state, are a rich resource for health and demographic research. It is through these documents that we obtain data on teen births, prenatal

care, low birthweight, smoking during pregnancy, and other important measures.

Birth certificates include an item on marital status, and this item allows us to monitor trends in nonmarital births.

OVERVIEW

I will be presenting both broad trends and some illustrative details on nonmarital

births. Much of this detail is important to grasping what has proven to be a complex

social and health issue. As you sort through all of the specifics, however, I want to

make sure that I convey these four important points.

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• Nonmarital births skyrocketed from 1940 to 1990 but the trends have stabilized

in the 1990’s, with a decline in the nonmarital birth rate since 1994. • Teens are not the only women having nonmarital births; in fact two-thirds of

nonmarital births are to women 20 and older. • Teen birth rates have declined considerably since 1991, with declines in all

states and in all racial and ethnic groups. • Nonmarital birth rates and teen birth rates have fallen for all population

groups, but most sharply for black women.

LONG TERM HISTORICAL TRENDS, 1940–90

Let’s look first at the long-term historical trends in nonmarital births, using three

key measures. These are (1) the birth rate for unmarried women, (2) the number

of births to unmarried women, and (3) the percent of all births that are to unmarried women. No matter how you look at the statistics, nonmarital childbearing rose

dramatically during the half century from 1940 to 1990, with somewhat larger increases in the 1980’s than in previous decades (table 1, figure 1).

The birth rate for unmarried women, which describes the proportion of unmarried

women who give birth, increased more than six-fold overall. Birth rates increased

for women in all age groups over this period (table 2, figure 2).

The two key trends contributing to the rising numbers of nonmarital births

through 1990 were the increased birth rates for unmarried women and the steep

increases in the number of unmarried women in the childbearing ages. The number

of unmarried women increased substantially as more and more women from the

large baby-boom generation postponed marriage, a trend that shows no sign of abating with the current generation. In other words, the combination of more unmarried

women who were also more likely to have a baby produced substantial increases in

the number of nonmarital births.

The percent of all births that are to unmarried women rose steeply because of

three concurrent trends: The increases in birth rates for unmarried women of all

ages; the increases in the number and proportion of women who are unmarried, explained above; and the considerable drop in birth rates for married women (dropping 40 percent from 1960 to the late 1980’s) (table 3, figure 3). Thus, the percent

of all births that were to unmarried women rose because births to unmarried

women increased while births to married women declined.

Data That Illustrate These Long-Term Trends

• The birth rate increased from 7 births per 1,000 unmarried women aged 15–

44 in 1940 to 44 per 1,000 in 1990 (tables 1 and 2, figure 1). • Trends in rates have been cyclical for most age groups, except the rates for

teenagers. Teen rates rose, almost without interruption, from 1940 to 1990. Rates

for women in their twenties and thirties rose steeply in the 1980’s, by at least 50

percent (table 2, figure 2). • Major changes in marriage patterns produced rapid growth in the number of

unmarried women in all age groups. Two-thirds of women in their early twenties

and about 40 percent of women in their late twenties are currently unmarried. • The number of nonmarital births rose 13-fold between 1940 and 1990, from

89,500 in 1940 to 1.2 million in 1990 (table 1 and figure 1). • The percent of all births that occurred to unmarried women rose seven-fold,

from 4 percent in 1940 to 28 percent in 1990 (table 1 and figure 1). Increases were

substantial in all age groups (table 4 and figure 4). • Increases in birth rates for unmarried women aged 20 and older have contributed to striking shifts in the age distribution of nonmarital births. By 1990, only

one-third were to teenagers compared with half in 1975.

CURRENT TRENDS

In contrast to previous decades, during the 1990’s nonmarital childbearing has

stopped rising and even declined in some age and race groups. The total number

of nonmarital births rose just 8 percent between 1990 and 1997, and has stabilized

in the last several years. Most of this increase was due to the continued increase

in the number of unmarried women. Birth rates for unmarried women, the other

factor, have stabilized and in some cases declined in the mid 1990’s (tables 1 and

2, figure 2). More importantly, the proportion of births to unmarried women has increased relatively little in the 1990’s. Since 1994, it has been essentially unchanged

at 32 percent, reflecting stability in birth rates for unmarried women and modest

increases in the number of unmarried women, coupled with declines in birth rates

for married women.

I will now review some of the current patterns in nonmarital childbearing.

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Variations by Race and Hispanic Origin

Nonmarital birth rates differ considerably by race and Hispanic origin. Reliable

rates can be computed for white, black and Hispanic women; population data by

marital status and race have not been available to allow us to compute similar rates

for other race and ethnicity groups except in census years. Rates for unmarried

black women have historically been higher than for white women, but the disparity

has narrowed because birth rates for unmarried white women have increased more

steadily than for unmarried black women (table 2).

The rate for unmarried white women more than doubled from 18 per 1,000 in

1980 to 38 in 1994, and has since declined slightly to 37. In contrast, the rate for

unmarried black women increased from 81 in 1980 to 91 in 1989 (about 12 percent),

and has declined steadily since to 73 per 1,000 in 1997 (down about 19 percent)

(table 2).

Rates for unmarried Hispanic women are available only since 1990. The rate was

highest in 1994, at 101 per 1,000, and has dropped 10 percent since. The birth rate

for unmarried Hispanic women is the highest of any race/ethnicity group; this is

consistent with the overall fertility patterns for Hispanic women.

Rates for unmarried women by age within race and Hispanic origin groups show

essentially the same trends as the overall rates by race and ethnicity. Rates have

fallen steeply for unmarried black women under age 35 (table 2).

Birth rates for married black women have declined even more than rates for unmarried black women and the rates are now much closer to each other (table 3).

As a result, the proportion of births to unmarried black women remains high, 69

percent in 1997. Birth rates for married as well as unmarried non-Hispanic white

and Hispanic women have generally stabilized or declined. As a consequence, the

proportions of births to unmarried non-Hispanic white and Hispanic women have

changed much less since the early 1990’s compared with previous years. In 1997,

22 percent of births to non-Hispanic white women and 41 percent of births to Hispanic women were nonmarital.

Teen Birth Rate Trends

Let’s look now at teen births. Although teen birth and nonmarital birth patterns

are often considered interchangeable, these rates are not the same. Teen birth rates

have declined considerably since 1991. The birth rate for teens aged 15–19 dropped

16 percent between 1991 and 1997, and it has continued to decline through June

1998, according to preliminary data. The rate for younger teenagers, 15–17 years,

fell 17 percent while the rate for older teens 18–19 dropped 11 percent. Of particular note, the birth rate for second births to teens who have had a first birth has

dropped substantially—by 21 percent—since 1991 (figure 5).

Despite the declines, however, most births that occur to teenagers are to unmarried teens. Birth rates for unmarried teens have declined steadily since 1994. The

rate for unmarried teens aged 15–17 fell by 12 percent from 1994 to 1997, while

the rate for older unmarried teens aged 18–19 fell 7 percent. To put these recent

declines in perspective, I should note that from 1980 to 1994, the rate for unmarried

teens aged 15–17 rose 55 percent, while the rate for teens 18–19 years rose 80 percent. Birth rates have dropped for unmarried non-Hispanic white, black, and Hispanic teenagers, but they dropped the most for black teenagers (table 2).

BEHAVIORAL CHANGES AND THEIR IMPACT

Data from CDC/NCHS’ National Survey of Family Growth, CDC’s Youth Risk Behavior Survey, and the NIH-sponsored National Survey of Adolescent Males can

help explain some of the recent declines in teen births and in nonmarital births.

These three separate surveys have all shown that the proportion of female and male

teenagers who are sexually experienced has stabilized and even declined in the

1990’s, reversing the steady increases that occurred over the previous two decades.

In addition, teenagers are more likely to use contraceptives at first intercourse, especially condoms. About 12 percent of all teenagers using contraception and one

quarter of black teenagers are using long-lasting hormonal methods including

injectable and implant contraceptives. These changes in contraceptive use are probably important factors in the decline in birth rates for second births to teenagers

who are already mothers (figure 5). The increases in contraceptive use reported for

teenagers are also found for older women. Also a factor for black women in their

late twenties and older is the continued high rates of voluntary female sterilization.

19

SUMMARY

I hope that my testimony has reinforced the four major points I made when I

began. First, nonmarital births rose dramatically from 1940 to 1990, but have since

stabilized with a decline since 1994. Second, teens do not account for all nonmarital

births; two thirds are to women aged 20 and older. Third, teen birth rates declined

considerably since 1991, nationally and across all states, but most teen mothers are

not married. Fourth, nonmarital births and teen births have fallen for all population

groups, but most steeply for black women.

Thank you for the opportunity to present these data. I would be pleased to answer

any questions you may have.

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25

Chairman JOHNSON of Connecticut. Mr. Zill—Dr. Zill.

f

STATEMENT OF NICHOLAS ZILL, PH.D., VICE PRESIDENT AND

DIRECTOR, CHILD AND FAMILY STUDIES, WESTAT, ROCKVILLE, MARYLAND

Dr. ZILL. Good morning. My name is Nicholas Zill. I am the

drector of the Child and Family Study area at Westat, a survey research firm in the Washington area. Over the last 24 years, I have

been conducting national surveys of the health and learning of our

Nation’s children and working to develop statistical indicators of

family and child well-being.

26

Three years ago, I had the privilege of testifying before this committee on unmarried parenthood as a risk factor for children.

Today, I come before you to report that significant progress has

been made in the last few years in slowing or reversing the explosive growth in unmarried childbearing that had been proceeding

unchecked since the mid-1960s. In the Nation as a whole and in

all major racial and ethnic groups, the proportions of children born

to unmarried parents in 1997 were no different or only marginally

higher than the comparable proportions that I previously reported

for 1993.

There have also been significant changes in the life circumstances of children who are growing up with unmarried mothers. More of these children have mothers who are employed and

working full-time, rather than being welfare dependent. More have

fathers who are paying at least some child support. As a result, the

average income of these families has increased, and the proportion

living in poverty has declined.

Despite these real and meaningful gains, the picture is far from

rosy. Although rates of unmarried childbirth have stopped increasing, they are still at levels that are three times higher than they

were in 1970. This year, nearly one in three children born in the

United States will be born outside of marriage. Much more change

is needed before the proportion returns to the relatively low levels

that it had been at for most of this Nation’s history.

There is a great deal of variation in the unmarried birth ratio

across racial and ethnic groups, as you can see in figure 1 in my

written testimony. Those groups that have been least successful

economically in our society exhibit much higher unmarried birth

ratios than groups that have been relatively successful. Among African Americans, for example, more than 2 out of 3 births are to

unmarried parents; among Mexican Americans, 4 in 10. Among

Japanese Americans, by contrast, 1 in 10 births is to an unmarried

mother. Efforts to increase educational and economic opportunity

for all minority groups are being thwarted by continued high rates

of unmarried childbearing.

Much more change is needed, as well, before unmarried parents

could be deemed to be living up to their financial responsibilities

to their offspring. I want to give you some of the numbers that illustrate some of the recent favorable trends, however, in the circumstances of children living with never-married mothers.

In 1993, less than half of the children living with never-married

mothers, 49 percent, had mothers who were in the labor force. By

1998, that proportion had grown to 69 percent, which is a 41 percent increase. The fraction of these children with mothers who

worked full-time grew from 28 percent in 1993 to 42 percent in

1998. That is a 50 percent rise.

The proportion receiving some support from the fathers of their

children increased from 15 percent in 1989 to 21 percent in 1995,

an improvement of more than a third. The median family income

of children with never-married mothers grew from $9,292 in 1992

to $12,064 in 1997, an increase of 30 percent. The proportion living

in families with incomes below the official poverty line improved

from 66 percent in 1992 to 58 percent in 1997, which is a 12 percent decline.

27

Despite these improvements, the economic circumstances of children living with never-married mothers remain dismal. This is so

even in comparison to the situation of children living with divorced

mothers, but especially in contrast to the far more favorable circumstances of children living with two parents. In my written testimony, I have made some detailed contrasts, which you can see in

Table 1.

Just to give you a few illustrations, 42 percent of children of

never-married mothers worked full-time in 1998, whereas the same

was true of 63 percent of children of divorced mothers. Fifty-one

percent of divorced fathers contributed to the child support of their

children versus 21 percent of never-married fathers. The poverty

rates, respectively, were 58 percent for children with never-married

mothers, 36 percent for those with divorced mothers and only 9

percent for those in two-parent families.

The elaborate child support enforcement mechanisms that have

been put into place in recent years are working fairly well for middle-class divorced parents who have conventional occupations. They

are working much less well for unmarried parents, many of whom

do not have a regular job or work only in the underground economy. Better ways must be devised to get unmarried parents who

live apart from their children to work and contribute regularly to

the support of the children they have fathered. By making sure

that the action of fathering a child has real consequences for the

young men involved, that they cannot simply walk away from their

responsibilities with impunity—and 79 percent of fathers are doing

that right now, are not providing any child support for their children—we will not only be improving the lot of the children involved, we will also be helping to reduce the frequency of unmarried conception and childbirth in the future.

In conclusion, I would urge this committee to track and be concerned not only about the rate and ratio of unmarried births, but

also about indicators of the life circumstances of children born and

being raised outside of marriage, indicators such as those I have

presented in this testimony.

I request that my written statement and the accompanying figures be placed in the record. Thank you.

[The prepared statement follows:]

Statement of Nicholas Zill, Ph.D., Vice President and Director, Child and

Family Studies, Westat, Rockville, Maryland

Good morning. My name is Nicholas Zill. I am the Director of Child and Family

Studies at Westat, a survey research firm in the Washington area. For the last 24

years, I have been conducting large-scale studies of the health and learning of our

nation’s children and working to develop statistical indicators of family and child

well-being.

Three years ago, I had the privilege of testifying before this committee on unmarried parenthood as a risk factor for children. I presented evidence showing that children born outside of marriage have a substantially greater risk of being raised in

poverty than children born to married parents. They also have more chance of suffering illnesses and injuries, experiencing difficulties in school, becoming victims of

crime, and growing up to engage in delinquent behavior or become teen parents

themselves.

It is not just the simple fact of birth outside of marriage that produces these increased risks, but a cluster of negative circumstances that usually accompanies unmarried parenthood in the United States. Related risk factors include parental immaturity and low parent education levels.

28

Today I come before you to report that significant progress has been made in the

last few years in slowing or reversing the explosive growth in unmarried childbearing that had been proceeding unchecked since the mid–1960s. For the nation

as a whole, and in all major racial and ethnic groups, the proportions of children

born to unmarried parents in 1997 were no different or only marginally higher than

the comparable proportions that I previously reported for 1993.

There have also been significant changes in the life circumstances of children who

are growing up with unmarried mothers. More of these children have mothers who

are employed and working full time rather than being welfare dependent. More

have fathers who are paying at least some child support. As a result, the average

income of these families has increased and the proportion living in poverty has declined.

Despite these real and meaningful gains, the picture is far from rosy. Although

rates of unmarried childbirth have stopped increasing, they are still at levels that

are three or more times higher than they were in 1970. This year, nearly one in

three children born in the United States will be born outside of marriage. Much

more change is needed before the proportion returns to the relatively low levels it

had been at for most of this nation’s history.

There is a great deal of variation in the unmarried birth ratio across racial and

ethnic groups, with those groups that have been least successful economically in our

society exhibiting much higher unmarried birth ratios than ethnic groups that have

been more successful. Among African-Americans, for example, more than two out of

three births are to unmarried parents. Among Mexican-Americans, four in ten.

Among Japanese-Americans, by contrast, one in ten births is to an unmarried mother. (See Figure 1 for further examples.) Efforts to increase educational and economic

opportunity for all minority groups are being thwarted by continued high rates of

unmarried childbearing.

Much more change is needed as well before most unmarried parents could be

deemed to be living up to their financial responsibilities to their offspring and before

the economic circumstances of children living with unmarried mothers could be described as even adequate. I would argue that changes such as increased child support from unmarried fathers and increased employment by unmarried fathers and

mothers would not only improve the lives of their children, they would also have

a beneficial feedback effect in reducing the numbers of children born outside of marriage in the future.

Here are some numbers that illustrate recent favorable changes that have occurred in the life circumstances of children born and being raised outside of marriage: • In 1993, less than half of children living with never-married mothers—49 percent—had mothers who were in the labor force. By 1998, that proportion had grown

to 69 percent, a 41-percent increase.

• The fraction of these children with mothers who worked full time grew from 28

percent in 1993 to 42 percent in 1998, a 50-percent rise.

• Although the unemployment rate among these mothers has remained very high,

it has eased slightly, going from 21 percent in 1993 to 17 percent in 1998.

• The proportion of never-married mothers with dependent children who received

some child support payments from the fathers of these children during the year increased from 15 percent in 1992 to 21 percent in 1995, an improvement of more

than one third.

• The median family income of children with never-married mothers grew from

$9,292 per year in 1992 to $12,064 in 1997, an increase of 30 percent (not adjusted

for inflation).

• The proportion living in families with incomes below the official poverty line improved from 66 percent in 1992 to 58 percent in 1997, a 12-percent decline.

Despite the improvements just enumerated, the economic circumstances of children living with never married mothers remain dismal. This is so even in comparison to the situation of children living with divorced mothers, but especially in contrast to the far more favorable circumstances of children living with two parents.

Here are some of the relevant comparisons:

• Whereas 69 percent of children living with never married mothers had mothers

who were in the labor force in 1998, the same was true of 81 percent of children

living with divorced mothers. Among children living with two parents, 88 percent

had at least one parent in the labor force, and 60 percent had both parents employed.

• Whereas 42 percent of children of never-married mothers had mothers who

worked full time, the same was true of 63 percent of children with divorced mothers.

• While 17 percent of children with never-married mothers had mothers who

were looking for work but unable to find it in 1998, the same was true of less than

29

7 percent of children of divorced mothers, and only 3.4 percent of children in twoparent families.

• The proportion of divorced mothers living with dependent children who received

child support from the fathers of those children in 1995 was considerably higher

than the comparable proportion for never married mothers: 51 percent versus 21

percent. The average amount of annual child support received by those who received

any support was also considerably higher among divorced than among never-married mothers: $3,990 (or about $333 per month) versus $2,271 (or about $189 per

month).

• Whereas the median family income for children with never-married mothers

was $12,064 in 1997, it was $21,316 for children with divorced mothers, and $52,553

for children in two-parent families.

• The respective poverty rates for children in 1997 were 58 percent for those with

never-married mothers, 36 percent for those with divorced mothers, and 9 percent

for those in two-parent families.

The way to reduce welfare dependency and combat childhood poverty is not to

hold unrealistic expectations about increased educational attainment among unmarried mothers and fathers. Every parent cannot be a college graduate, nor should we

expect that everyone needs to be in order to make ends meet. The way to accomplish

both goals is to insure that all men and women who bring children into the world

work steadily and make regular and meaningful contributions to the financial support of their children. This should be the case whether the parents are married or

unmarried.

The elaborate child support enforcement mechanisms that have been put into

place in recent years are working fairly well for middle-class divorced parents who

have conventional occupations. They are working much less well for unmarried parents, many of whom do not have a regular job or work only in the underground

economy. Better ways must be devised to get unmarried parents who live apart from

their children to work and contribute regularly to the support of the children they

have fathered. By making sure that the action of fathering a child has real consequences for the young men involved—that they cannot simply walk away from

their responsibilities with impunity—we will not only be improving the lot of the

children involved. We will also be helping to reduce the frequency of unmarried conception and childbirth in the future.

In conclusion, I would urge this committee to track and be concerned not only

about the rate and ratio of unmarried births in the U.S., but also about indicators

of the life circumstances of children born and being raised outside of marriage, indicators such as those presented in this testimony.

30

31

your entire statements in the record for both witnesses.

Chairman JOHNSON of Connecticut. Thank you. We will place

f

To what extent is this decline in nonmarital births related to demographics, a decline in the number of women of childbearing age?

Ms. VENTURA. That is an issue. The childbearing age population

is getting older, and older women are less likely to have nonmarital

births; but even so, the rates have declined for women in all age

groups. So that is the other part of it. The long-term increases were

for all age groups, and the recent declines have been drawn from

most age groups.

32

Chairman JOHNSON of Connecticut. How much do we know about

how much this decline is related to abstinence and how much is related to contraceptive use?

Ms. VENTURA. The data from the National Survey of Family

Growth and the CDC Youth Risk Behavior Survey and also the National Survey of Adolescent Males have all shown that there has

been a decline in sexual activity among teenagers in the 1990s, and

among those who are sexually active, an increase in contraceptive

use at first intercourse. For the really high-risk teenagers, those

who have already had a baby, there has been an increase in the

proportion of who are using the long-lasting hormonal methods.

We have not been able to sort out exactly how much of the decline is accounted for by abstinence and how much is accounted for

by changes in contraceptive use. I think they are both important,

but we haven’t been able to apportion them precisely.

Chairman JOHNSON of Connecticut. Would you have any comment on that, Dr. Zill, particularly on this issue of the specific role

of abstinence programs and the change as it resulted and the sort

of commonness of that discussion? I mean, years ago there was no

talk of abstinence at all, during the 1970s and 1980s, and now

there is; and there are programs out there that are planting this

idea more broadly where teenagers can hear it. What evidence do

we have that this is being heard and thought about by kids?

Dr. ZILL. Well, I would point to a couple of things.

First, as far as demographics are concerned, the changing ethnic

and racial composition of our population would actually lead you to

expect more nonmarital births. So I think the leveling-off is particularly impressive, given that. I think you also have to think,

though, in terms of the future prospects and the calculations—the

unconscious calculations—that go on in young people’s minds. I

think many minority teenagers have seen the very bad example of

their parents who became crack addicts, who had teen births, who

wound up in poverty and welfare dependence, often in institutions.

And I think some of what is going on in terms of refraining from

sexual activity, as well as using contraceptives, is that the prospects for young women, particularly with our Nation’s effort to increase educational and economic opportunities, are better. So more

of them are saying, I don’t want to get into the losing pattern that

I saw my mother and my aunts develop. I think we have to focus

on that rather than simply lecturing to children about sexual behavior.

There is still a great deal of sexual activity in our society, and

the mass media encourage it all the time. There is always the message out there that sex has no consequences, it is just fun, don’t

worry about it. It is still very cool for a lot of young men to father

children without living up to the consequences; I think we have to

change some of that. But I think we also have to think in terms

of the real life prospects of the young people involved and make

sure that they have better opportunities than becoming a welfare

mother or becoming a teen mother, and I think that has to be part

of it, rather than just thinking of these techniques of contraception

or thinking of abstinence apart from that larger socioeconomic picture.

33

Chairman JOHNSON of Connecticut. I think there is increasing, at

least anecdotal, evidence that the kids, that the mothers who are

leaving welfare are impressed and tend to be more interested in

school and begin to see their opportunities as different. I can remember going to kindergartners and asking kids what they wanted

to do when they grew up and having them actually answer, I am

going to be on welfare. So I think—I don’t know to what extent sort

of that opening of opportunities is influencing the birthrate and to

what extent the more public conversation about abstinence is influencing it, the greater availability of better contraceptive options is

influencing it.

But I do think the talk about abstinence, and I do see my—the

Governor of Texas’ comments in quite a different light than my colleague or than Mr. Cohen of the Washington Post. I think it is

healthy that he is visiting abstinence programs. I think it is important that the conversation get better balanced about the benefits of

abstinence, particularly in an era of extraordinarily dangerous sexually transmitted diseases.

And so I think we need to rebalance the message, and the abstinence programs are a part of doing that, with the delay in marriage rates. As to whether we can or want to influence adults beyond discouraging them from having children without the support

of the whole family is a different question, but I do think the abstinence programs are important.

So I appreciate your testimony today.

Mr. Cardin.

Mr. CARDIN. Thank you, Madam Chair.

Is there any evidence that sexual activity among teenagers has

declined?

Ms. VENTURA. Yes.

Mr. CARDIN. Give me some specifics. What type of information do

we have? How do we know that?

Ms. VENTURA. We have information from the National Survey of

Family Growth, which is a survey of women in the childbearing

ages. We have information from the Youth Risk Behavior Survey

that CDC operates, and also from the——

Mr. CARDIN. And how is that information presented?

Ms. VENTURA. Well, they have published the findings through

1997.

Mr. CARDIN. And what age groups—is it all age groups?

Ms. VENTURA. The National Survey of Family Growth is for all

age groups. The other two surveys are just for teenagers or the

school-age population. The published results have shown that for

teenagers there has been a decline in sexual activity.

Mr. CARDIN. And do we know the percentage decline?

Ms. VENTURA. It is modest.

Mr. CARDIN. Is it equal to the decline in pregnancies?

Ms. VENTURA. No.

Mr. CARDIN. So we have had a larger decline in pregnancies than

we have had in sexual activity decline, but we have seen a decline?

Ms. VENTURA. Right.

Mr. CARDIN. So, therefore, in following up Mrs. Johnson’s question, abstinence to a certain degree has—whatever policies we have

used, there has been a decline in sexual activity, but also contraVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00037 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
34

ceptives would at least be responsible for some of the decline in

pregnancies in the last 6 or 8 years——

Ms. VENTURA. Yes.

Mr. CARDIN [continuing]. The combination of the two has been

successful, at least in reducing the growth rate, and in some cases,

actually declining the amount of teenage pregnancies.

Ms. VENTURA. Yes.

Mr. CARDIN. Dr. Zill, you mentioned a very interesting point that

I hadn’t thought about. I thought about it in reverse, and that is,

if the child is born to a teenage mother, is that child more likely

to be a teenage mom?

Dr. ZILL. There is some evidence of that.

Mr. CARDIN. The answer is—I thought it would be yes.

Dr. ZILL. It is.

Mr. CARDIN. But then you are saying that you see your parent,

as an example, as very unsuccessful economically or ending up in

prison or ending up with serious abuse problems. You don’t want

that to happen to yourself, therefore, don’t go down the same path;

or you don’t want to see it happen to your child, so don’t become

pregnant.

Dr. ZILL. Well, it is like the children of alcoholics, some of them

become alcoholics while others become teetotalers. There is something of a bimodal distribution.

Mr. CARDIN. But your first—we know that if you live in poverty,

you are more likely to become a teenage parent. We know the problem. I guess we don’t know why—it seems—why do we have teenage pregnancies? What are the reasons? I mean, you are giving us

some of the statistical information.

Dr. ZILL. A lot of the women who become teenage mothers are

academic failures. They don’t have many prospects in front of

them. They don’t see a bright future in their schools or in their occupations. The examples in their neighborhood, as Mrs. Johnson

said, most of them are welfare mothers, and many of them are fathers who don’t support their kids. So in their calculations, in

many instances, welfare motherhood seemed like a pretty good opportunity to at least have some sense of an adult role and respect

from others.

Mr. CARDIN. I have heard that explanation given before, some degree of accomplishment, have a child.

Dr. ZILL. Right.

Mr. CARDIN. That is still prevalent today from what you are——

Dr. ZILL. Well, I think you can see that even in the inner city,

that the students who are doing well or who have sports scholarships in front of them are much less likely to become pregnant.

Also, those involved in meaningful activities, like the school band,

we found in some research we did, were less likely to have teen

pregnancies. The important thing is some sort of positive involvement, some sort of path that goes away from motherhood as the

principal accomplishment.

Mr. CARDIN. Have there been any studies done as to the impact

that sex education programs have had in our schools on teenage

pregnancies? Has there been any effort made to try to equate the

exposure of children to quality sex education curriculum in schools

and what impact that has had on teenage pregnancy?

35

Dr. ZILL. There has been some. The evidence I know about is not

very encouraging. I think the stronger evidence is that if there is

value-based instruction for children and if the family supports it or

if important peers support it, then there is likely to be an effect.

But value-neutral sex education is not effective.

Mr. CARDIN. And what do you base that on?

Dr. ZILL. The evidence that is out there.

Mr. CARDIN. Well, I think it would be very useful if you can

make that available to our committee. I would welcome the opportunity of looking at and exploring the methodology used on these

evaluations.

I think we all want to achieve the results of less teenage pregnancies, and we want to deal with the issues that you have brought

forward. It is difficult to deal with this in the abstract, and there

are a lot of competing philosophies around this place, and if we are

ever going to be able to get any degree of consensus on government

policy in this area, then we are going to have some degree of confidence that we are going to enact something that really will deal

with the underlying problem.

My own thought is that good programs in schools dealing with

young people who may not have the best role model at home, or

the best example at home, could be a very helpful part of the overall equation here to reduce the teenage pregnancy rate; but how

that is structured and who has the most effective program and

whether we are sharing that information and whether we have a

national commitment to that is something I am not certain about.

So I would appreciate it if you would make available to us the

specifics of the studies that you are referring to and, if possible, the

methodology that was used in those surveys.

Thank you, Madam Chair.

Chairman JOHNSON of Connecticut. I would like to just follow up

on two questions.

Dr. Zill, you mentioned that 51 percent of divorced mothers—Dr.

Zill, sorry—that 51 percent of divorced parents received child support payments and even after all the effort we have made, only 21

percent of nonmarried fathers contribute.

Now, we are thinking about a fatherhood initiative. Who are we

going to reach and what about that great majority of the fathers

of the unmarried mothers’ babies that we are not even reaching

through child support enforcement and paternity determination requirements? I mean, that seems to me astounding that given paternity determination requirements to be eligible for the welfare system, we are still not—is it that we are not collecting from more

than 20 percent? We have reached some of the others, but they

have no money? And are 80 percent really beyond our communications network?

Dr. ZILL. Well, I think some of these changes are just being instituted now. So it is going to take a while for them to really work

themselves out. It is not an easy problem because, as you said,

many of the young men don’t have the kind of jobs where you can

garnish their wages easily. Some of them may be in prison, some

of them may be working in the underground economy. But we really have to make more of an effort.

36

I feel that a lot of the child support mechanisms have gone to

the easy place, the way a drunk looks for the keys where the light

is. We are doing a great job with these middle-class fathers where

we can garnish their wages. In fact, we are probably being overenthusiastic with them. But with the tougher cases, we are not

doing a good job.

I think there is a lot of interesting research going on now with

unmarried fathers and I think we can learn a lot from that. Rebecca Maynard, who is going to testify later, could probably provide

some concrete suggestions in terms of programs that can be effective. But currently 79 percent of the unmarried fathers have no

consequences of fatherhood. And so much of welfare reform has focused on the mothers; we really need to put the responsibility on

the fathers as well.

For example, right now, a lot of people are saying, well, we need

to give welfare mothers enough education to support their children—college educations. Well, everybody is not going to become a

college graduate. But even at relatively low-paying jobs, if both the

mother and the father cooperate, it is possible to get out of poverty;

and we have to have more of both parents helping support their

children, even if they are unmarried.

Chairman JOHNSON of Connecticut. Well, we did make—the

Ways and Means Committee made dramatic changes in the support

for higher education, and frankly, anybody working now can go get

a community college degree, absolutely for free, through tax cuts.

So to do that, you have to have a way to share at daycare and

things like that, and that means cooperation between both parents.

But we are going to be doing a fatherhood initiative, and any

thoughts you have on how we reach out, we would be interested.

And one last question, what do we know about abortion? How

consistent and of what quality is the abortion data from States,

and has there been any increase in abortion since welfare reform?

Ms. VENTURA. Actually, the National Center for Health Statistics

doesn’t collect abortion data, but I can tell you briefly what I know

about it.

The States vary in completeness in the reporting of abortion. Although it is reported in all States, the coverage varies dramatically.

The States provide information on abortions to the CDC in Atlanta,

that is, tabulated data. It is not like the National Vital Statistics

System where each individual record is reported, so there is not the

same oversight. It is not the same kind of relationship between the

Federal and the State governments to provide this data.

From what we see, the abortion rates and the ratios and percentages are all declining. They have been declining for a number of

years actually, even longer than the teen pregnancy rates have

been going down.

Chairman JOHNSON of Connecticut. Well, thank you very much

for your testimony. We appreciate it and thank you for being with

us.

Let’s see, the next panel is Dr. Richard Nathan, director of the

Rockefeller Institute of Government in Albany; Robert Rector, a

senior policy analyst for the Heritage Foundation; Isabel Sawhill,

senior fellow, Economic Studies, Brookings Institution; Pat Funderburk Ware, president and chief executive officer of PFW ConsultVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00040 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
37

ants; and Cory Richards, vice president for Public Policy, Alan

Guttmacher Institute.

Welcome.

Richard Nathan, would you begin, please.

STATEMENT OF RICHARD P. NATHAN, DIRECTOR, NELSON A.

ROCKEFELLER INSTITUTE OF GOVERNMENT, ALBANY, NEW

YORK

Mr. NATHAN. Thank you very much, Madam Chair. The emphasis of our research is on implementation, what is happening in

State and local governments and in social program bureaucracies

as welfare reforms are implemented; and I will just highlight the

double-spaced part of my testimony.

The first report of our 20-State implementation study showed

that the governors and State legislatures have adopted welfare reforms that strongly signal the importance of the work objective.

We do not, however, find similar widespread policy or administrative support for the act’s anti-reproduction goals. Legislative

proposals and often tentative administrative policy initiatives to

change sexual behavior have been advanced in some States, but

often they are dropped, watered down or deemphasized at the front

line by the workers, which is critical in this area because this issue

elicits controversial attitudes that probably can’t generate statewide support in any State.

The essential challenge involves disagreements about, as you

have discussed, the methods for preventing teen pregnancy and

out-of-wedlock births. The basic divide is between abstinence and

a distribution of contraceptives.

In the next section of my testimony, on page 2, I talk about defining ‘‘deviance up,’’ to take a line and reverse it from Senator

Moynihan. This is a time when social policy is changing values in

the education area, in the welfare area and in the housing area—

all across the board. The Personal Responsibility Act is aptly

named.

In the work area, the national consensus has been loud and clear

for a long time, but in the other major area, where the signaling

of the 1996 Act is even stronger, the picture is less clear.

The next section of my testimony lists four lessons from our management research in the States, first of all, about how devolution

is increasing dramatically. I have been in this field a long time. I

am really impressed by this.

The second point is that the real story of devolution is second

order and tertiary devolution down to local levels.

The third point is that in the super-sensitive area of pregnancy

prevention, this push to the local level is particularly powerful. It

is like a hot potato: Pass it along for somebody else to deal with

it according to the values that prevail in local communities.

And the fourth point from our research is that the main bureaucracies involved (the work and welfare bureaucracies) don’t connect

easily or often with health bureaucracies and family planning clinics, and that is a big challenge.

The next part of my testimony deals with this problem as an opportunity to make linkages. We are doing work at the Rockefeller

Institute with the General Accounting Office on what we call, as

38

I say on page 5 of my testimony, ‘‘connectivity.’’ The key to welfare

reform is building systems that connect social programs, food

stamps, Medicaid and many social services. It is not just a matter

of knowing what we do. It is also a matter of doing what we do.

Information technology now provides the power to make these connections at the front lines.

Some States are working hard on this. Teen pregnancy prevention and prevention of out-of-wedlock births, however, is usually

not on this screen, as I say in the testimony, either figuratively or

literally.

Skipping along in the testimony, the highlight and central point

of our research is that signaling matters, that while administrative

procedures may not be changing materially and in deep and substantial ways because of uncertainty about this policy area, the signaling about work and time limits on welfare, although I can’t

prove it, I believe has contributed materially to the declines that

we just heard about in teen births and in out-of-wedlock births.

Other factors, for example, fear of AIDS and technology (new technology for birth control), obviously also contribute, and it is impossible to know what is causing what.

The last line of my testimony brings out what I think is the essential dilemma of this hearing. Last week we saw the new Austin

Powers movie, ‘‘The Spy Who Shagged Me.’’ I looked up ‘‘shag’’ in

my dictionary. It is what baseball players do in the outfield when

they are practicing. Lots of people were there the afternoon we

went to the movie with children—10, 11, 12 years old. The popular

culture incessantly signals a set of permissive values about sexual

behavior, while at the same time the political culture gives a decidedly different and very strong signal about abstinence and family

integrity; and that is why, as we say, the administrative challenge

in this area is such a big and very complicated one.

I thank you very much for the chance to present testimony. I ask

that the whole statement be put in the record.

Chairman JOHNSON of Connecticut. Thank you. All the statements will be put in the record in their entirety, and I would just

like to comment, Mr. Nathan, I did very much enjoy your report

on your 20-State study and found it very, very helpful, and have

given it to my State people responsible for improving the functioning of our State program as that lack of connectivity is still a

problem.

[The prepared statement follows:]

Statement of Richard P. Nathan, Director, Nelson A. Rockefeller Institute

of Government, Albany, New York

PREVENTING TEEN AND OUT-OF-WEDLOCK BIRTHS THROUGH WELFARE REFORM

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996

(PWORA) was intended to discourage welfare recipiency, promote work and marriage, and reduce out-of-wedlock births and teen pregnancies. The first report on the

20-state implementation study of the Act conducted by the Rockefeller Institute of

Government shows that governors and state legislators have adopted welfare reforms that strongly signal the importance of the first of these two objectives—work.

39

1 Nathan, Richard P., and Thomas L. Gais. Implementing the Personal Responsibility Act of

1996: A First Look (Albany, NY: The Nelson A. Rockefeller Institute of Government, 1999). Copies available from the Rockefeller Institute call Michele Charbonneau (518–443–5258).

Work-oriented welfare reforms often have been undertaken enthusiastically by bipartisan political coalitions.1

We did not however find similar widespread policy or administrative support for

the Act’s anti-reproduction goals. Legislative proposals and often tentative administrative policy initiatives to change sexual behavior have been advanced in some

states, but often they were dropped, watered down, or de-emphasized before state

welfare reform legislation was passed or broad executive orders promulgated. This

issue elicits controversial attitudes and proposals that probably could not generate

broad support in any state. In Mississippi, for example, the state’s original welfare

reform bill in 1992 included provisions calling for Norplant implants for AFDC recipients with four or more children and a thousand dollar ‘‘reward’’ to women who

married and left the rolls, but these components were dropped from the bill before

it was enacted into law (Mississippi Field Research Report, 1998).

The essential challenge in this policy area involves disagreements about the methods for preventing teen pregnancy and out-of-wedlock births. The basic divide is between abstinence and the distribution of contraceptives. In Utah, front-line workers

are not allowed to discuss birth-control options with welfare clients. In Washington

State, field reports indicate that front-line workers do not feel it is appropriate to

discuss such personal issues with clients, even though state policy is permissive in

this respect. One New York City official told our field researcher, ‘‘Ninety percent

of our workers are themselves single parents and identify on that point with their

clients’’ (New York State Field Research Report, 1998).

In the world of welfare, this subject tends to be off limits. The political problem

is the obvious one: While there may be a consensus on the wisdom and desirability

of preventing pregnancies among teens and out-of-wedlock births among the TANFeligible population, there is not a consensus on how to do it. Despite this and although I can’t prove it, I believe the signaling changes of welfare reform are having

an impact in reducing teen and out-of-wedlock births. This is more a result of policy

than administrative changes, but the latter are occurring. There is increasing

awareness of opportunities, especially at the local level, for linking job and family

policies as part of the broad national effort to ‘‘end welfare as we know it.’’

DEFINING DEVIANCE UP

In the U.S., there is a view—a wrong headed one—that governments cannot influence social values and change cultural attitudes. In fact and completely to the contrary, governments do their most important work when they seek to influence social

values. The current period is a perfect example of a time when governments—national, state, and local—turning around a phrase Senator Moynihan likes to use—

are hard at work trying to define deviance up. The national movement to promote

competition in education by raising school standards through student testing and

the introduction of charter schools and vouchers has a major analog in the welfare

area in the powerfully stated twin goals of the 1996 national welfare reform act to

promote work and discourage teen pregnancy and out-of-wedlock births. Similar

policies that reflect the goals of the 1996 welfare reform act are embodied in the

Federal Housing Act of 1998.

The Personal Responsibility Act is aptly named. The Act has generated efforts to

inculcate personal-responsibility values in government that I believe over the long

haul will be viewed as part of a cultural shift in America rivaling the equal and

opposite cultural shift to personal-permissiveness values in the mid-1960s.

Government can do things that have broad citizen support. For welfare policy in

America, signals have changed. This is certainly the case of the work-first goal of

the 1996 law, which has broad and deep citizen support. In this area, the national

consensus has been loud and clear for a long time. But in the other major area

where the signaling of the 1996 Personal Responsibility Act is even stronger than

in the work area, the picture is less clear.

LESSONS FROM THE IMPLEMENTATION RESEARCH

The Rockefeller Institute 20-state study of the implementation of the 1996 Personal Responsibility Act provides important lessons that apply to the goal of reducing teen pregnancy and out-of-wedlock births:

40

2The GAO report stated: ‘‘States generally gave localities the flexibility to choose the type and

mix of programs they wanted to put in place.’’ See: ‘‘Teen Pregnancy: State and Federal Efforts

to Implement Prevention Programs and Measure Their Effectiveness.’’ (Washington, D.C.: U.S.

General Accounting Office, GAO/HEHS–99–4) November 1998, p. 3.

• First, we found a definite, strong move to devolution for domestic policy, one

that applies broadly to welfare, employment programs, and social services related

to employment. • Second, we found extensive second-order and tertiary devolution— that is, the

assignment of increased responsibilities for devising strategies and setting up systems to combat family dependency to local governments, local offices of state agencies, and private groups (often nonprofit organizations). • Third, in the super-sensitive area of pregnancy prevention, this push to localize

and decentralize is especially powerful. A November 1998 report from the GAO

reached a similar conclusion.2 This political hot potato is regularly tossed to local

leaders and groups to handle as they so choose because the values and attitudes

involved are so diverse in the country. In liberal communities, providing contraceptives and even abortions is accepted. In others, they are a source of great friction. • Fourth, the institutions and agencies responsible for preventing teen pregnancy

and out-of-wedlock births do not connect well or easily with welfare and employment

bureaucracies, even in communities where liberal attitudes prevail on pregnancy

prevention. Welfare and employment bureaucracies are increasingly linked all over

the country, though their relations are often tense. However, an important and pervasive finding from our 20-state field data is that neither of these two major types

of agencies—welfare or employment agencies—have close ties with health agencies

or local public health clinics, particularly family planning clinics.

I believe this problem—the problem of the lack of connections between welfare

and employment and health agencies and operations—provides an opportunity. The

opportunity is for leaders and groups committed to teen pregnancy prevention and

the prevention of out-of-wedlock births, regardless of the approach they favor, to

forge linkages to welfare and employment policies and bureaucracies. Of course, saying that forging stronger linkages are the key as next steps is a lot easier than taking such steps. However, in light of the fact that a major purpose of the 1996 welfare reform act is to prevent teen pregnancy and out-of-wedlock births, the clear and

present need is to do this to make such connections. Government agencies, foundations, and private nonprofit organizations that care about this policy objective would

benefit by building relationships at the ground level between health agencies and

welfare-job systems.

‘‘CONNECTIVITY’’ THE KEY

The new all-purpose, five-syllable word in our research on welfare implementation

is connectivity. Controversies have arisen about connections among social programs

as welfare becomes ever more focused on jobs. The biggest controversies have been

about the effects of reductions in welfare rolls on participation in the Food Stamp

and Medicaid programs. This connectivity idea, however, is even broader. It involves, not only income-support for families, but also child care, health, transportation, and a range of employment and family and children’s services to enhance

family self-sufficiency. Looking across the board, the lack of connectivity in the case

of pregnancy prevention is the most striking among all the areas that could be keys

to helping poor families become and remain stable, healthy, and independent.

For the past two years the Rockefeller Institute of Government and the U.S. General Accounting Office have conducted a ‘‘Working Seminar on Social Program Information Systems,’’ a permanent group that meets quarterly on the mechanics of social program connectivity. The overarching purpose of the working seminar is service

integration. For decades, people have talked about holistic strategies to overcome

the bureaucratic separation of social program fiefdoms. Information technology now

provides the power to make these connections at the front lines. Some states are

working hard on this. Teen pregnancy prevention, however, usually is not on this

screen—either figuratively or literally.

CHANGE HAS OCCURRED

Despite this finding that the pregnancy-prevention objectives of the Personal Responsibility Act have so far had relatively little effect on the behavior of welfare and

job bureaucracies, there are grounds for expecting personal behavior in this area to

change as a result of the Act, and indeed I believe it is already changing. TANFaided family heads (most of them female, and many of them unmarried) face a new

reality of time-limited cash assistance and more serious requirements for work and

41

3 National Campaign to Prevent Teen Pregnancy. Whatever Happened to Childhood? The Problem of Teen Pregnancy in the United States. (Washington, D.C., 1997) 4 ‘‘Preventing Teenage Pregnancy,’’ HHS Fact Sheet (Washington, D.C.: U.S. Department of

Health and Human Services, April 29, 1999) 5GOA/HEHS–99–4, p. 1.

6Levin Epstein, Jodie. State TANF Plans: Out-of-Wedlock and Statutory Rape Provisions

(Washington,. D.C.: Center for Law and Social Policy, 1997)

participation in work-search and related activities. They have to participate in workrelated activities for fixed amounts of time under negotiated ‘‘Personal Responsibility Agreements’’ that states require be signed before a TANF cash-assistance case

can be opened. If there is a noncustodial parent, usually a male, there is now a new

social dynamic: ‘‘If he isn’t required to do anything, why should I be; why shouldn’t

he be responsible too?’’ State officials predict that this kind of attitude change and

the resentment evoked by time-limited cash assistance is already affecting childbearing behavior, and that this signaling effect will increase.

The most prominent finding from our 20-state research on the implementation of

welfare reforms is precisely in this area—that signaling matters. Teen births in the

U.S. are the highest in the industrialized world (twice as high as Great Britain

which ranked second). Actually, teen births are declining now—and at an increasing

rate.3 Overall, teen births declined from 62.1 per 1,000 teens aged 15–19 in 1991

to 52.3 in 1997, the latest year for which we have data.4 In my opinion, though I

cannot prove it, stronger signaling in welfare policy has contributed materially to

this decline. Other factors, too—fear of AIDS and new technology (notably DepoProvera)—have also contributed. But determining causality in this super-sensitive

policy area is impossible.

Note: Additional information on findings from the Rockefeller Institute’s Implementation Study of the Personal Responsibility Act of 1996 is presented in the sections that follow. I request that the full statement, including this material, be printed in the hearing record.

STATE RESPONSES

A November 1998, GAO report stated:

Teenage pregnancy and parenthood have unfortunate consequences for society, teenage mothers, and the children born to them. Teen mothers frequently

do not complete high school, have poor earnings, and have increased dependency on the welfare system. A child born to a teen mother is more likely to have

a low birthweight and health problems, suffer abuse, live in an inferior home

environment, be poor, and be less likely to succeed in school. Moreover, a child

born to a teen is more likely to become a teenage parent.5

Given the clashes over values in this policy area, most states have adopted indirect approaches to get at this challenge. Changes in reproductive behavior tend to

be treated as expected side-effects of welfare reform policies. The Rockefeller Institute’s research team in Wisconsin put it this way:

Certainly the architects of W–2 expect the program over time to reduce nonmarital births, mostly because mothers can no longer receive cash assistance

without working and because teen parents must live in an adult-supervised setting to receive W–2 services or support. . . . But reduction in out-of-wedlock

pregnancies is a hoped-for by-product of W–2. . . . The program has no components aimed exclusively at the issue, and W–2 agencies have no formal role in

preventing out-of-wedlock pregnancies. (Wisconsin Field Research Report, 1998;

emphasis added.)

Nine states in the Rockefeller Institute sample created task forces on teen pregnancy prevention to deal with this subject, a familiar tactic to put off action in sensitive, controversial policy areas. While many aspects of this policy area are controversial, some provisions of the 1996 welfare reform legislation were rather quietly

enacted, for example, the requirements that teen mothers live at home or in an

adult supervised setting and that they stay in school.

Some states are trying to find a middle ground that is not ideologically charged,

an approach that offends neither liberals nor conservatives. In West Virginia, for

example, there is a marriage incentive, a ten percent increase in the monthly cash

grant for two-parent families.6 The relative popularity of family caps—twenty states

now have them—reflects the same purpose, i.e., to discourage the birth of additional

children without specifying how those births are to be prevented. However, the politically attractive ambiguity of this approach may not last. Recent studies of the

effects of family caps in New Jersey conducted by researchers at Rutgers University

42

7Preston, Jennifer. ‘‘With New Jersey Family Cap, Births Fall and Abortion Rise.’’ The New

York Times, November 3, 1998. 8 Haskins, Ron and Carol Statuto Bevan. ‘‘Abstinence Education Under Welfare Reform.’’ In

Abstinence Education Grants and Welfare Reform Seminar web page. College Park, MD: University Maryland Welfare Reform Academy, MD, 1997 (cited March 18, 1999). Available from

http://welfareacademy.org/pubs/main.htm 9 Cohen, Marie. Tapping TANF: When and How Welfare Funds Can Support Reproductive

Health of Teen Parent Initiatives (Washington, D.C.: Center for Law and Social Policy, April

1999).

See also an excellent analysis by Sawhill, Isabel V. Teen Pregnancy Prevention: Welfare Reform’s Missing Component (Washington, D.C.: Brookings Institution, November 1998) 10Social Security Act, U.S. Code Annotated, Vol. 42 Secs. 602(a)(15)(A)(7) (1991). 11 Congressional and Administrative News, Legislative History, 1972, P.L. 92–603.

suggest they may increase the incidence of abortions, thus casting doubts on their

political acceptability.7

‘‘THE DEVOLUTION IS IN THE DETAILS’’

The Personal Responsibility Act complicates this value-reconciliation challenge. It

makes $250 million available over five years for abstinence-only education programs

to be administered by the states. There is a detailed set of regulations that must

be followed to obtain this money. To be funded, a program must:

1. Have as its exclusive purpose, teaching the social, psychological, and health

gains to be realized by abstaining from sexual activity;

2. Teach that abstinence from sexual activity outside marriage is the expected

standard for all school-age children;

3. Teach that abstinence from sexual activity is the only certain way to avoid outof-wedlock pregnancy, sexually transmitted diseases, and other associated health

problems;

4. Teach that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity;

5. Teach that bearing children out of wedlock is likely to have harmful consequences for the child, the child’s parents, and society;

6. Teach young people how to reject sexual advances and how alcohol and drug

use increases vulnerability to sexual advances; and

7. Teach the importance of attaining self-sufficiency before engaging in sexual activity.8

Most states have applied for and received their allotments under this grant, but

it is not clear that they will actually use the money. Many state officials see the

abstinence-only program requirements as restrictive. They often do not understand

that TANF and MOE funds can also be used for other pregnancy prevention approaches, such as family planning counseling and the provision of contraception—

that is, if states choose to do so.9

In the opinion of one state official, ‘‘few projects will be able to implement faithfully all components of the definition in the law’’ for abstinence-only programs.

These provisions, which require programs to teach that ‘‘a mutually faithful

monogamous relationship in the context of marriage is the expected standard of

human sexual activity,’’ have come under scrutiny. State officials have told our field

researchers they are wary about setting aside money for abstinence education because there are few studies that have linked abstinence programs with the reduction in out-of-wedlock births, although the U.S. Department of Health and Human

Services is currently supporting evaluations of abstinence-only programs. Finally, to

use abstinence-only funds, the state needs to match every four federal dollars with

three state dollars. This matching requirement has proven difficult in some states,

in part because of the fear that the money used for abstinence-only education competes or conflicts with funding for other efforts to prevent teen pregnancies and outof-wedlock births.

Imposing requirements on the states to take steps to prevent teen pregnancy is

not new, though the emphasis on abstinence is. In 1967, a law was enacted that

required states to offer family planning services ‘‘in appropriate cases’’ to recipients

of Aid to Families with Dependent Children (AFDC), for the purpose of ‘‘preventing

or reducing the incidence of births out of wedlock.’’ The 1972 amendments explicitly

included sexually active minors in the definition of ‘‘appropriate cases,’’ and required

that family planning services be ‘‘provided promptly’’ to all who requested them.10

The 1972 amendments also established a penalty if states failed to comply with

these requirements and provide family planning services under Medicaid.11 The requirement that AFDC clients be given information on family planning remained on

the books until it was repealed by the 1996 welfare law.

43

In addition to the abstinence-only emphasis in the 1996 Act, there are financial

incentives to states tied to pregnancy prevention. Two bonuses provided in the Act

are to be given to the states with the best performance. The first is the ‘‘Bonus to

Reward High Performance States.’’ The federal government will reward states that

best achieve the purposes set forth by the Personal Responsibility Act (all of the

goals, not just those related to reproduction-reduction). Standards for this bonus

were established by the Secretary of the U.S. Department of Health and Human

Services in consultation with the National Governor’s Association and the American

Public Welfare Association, now the American Public Human Services Association.

One of the four goals on which performance bonuses are based is the reduction of

out-of-wedlock births. One hundred million dollars per year is available for fiscal

years 1999 and 2000.

In addition, a specific ‘‘Bonus to Reward a Decrease in Illegitimacy’’ makes $100

million available, to be shared by the five states that demonstrate the greatest reductions in out-of-wedlock births. To qualify for the bonus, states must demonstrate

that the abortion rate is less than the FY 1995 level. It is important to note that

both of these bonuses are directed at the state’s entire population, not only teens

or welfare recipients. These financial incentives, however, do not appear to be promoting active policy initiatives and administrative linkages between welfare and

pregnancy prevention.

AGENCY INTERRELATIONSHIPS

The most significant institutional barrier to linking pregnancy prevention and

welfare/job programs is the fact that pregnancy prevention programs are administered by health agencies, local health clinics, family planning clinics, and education

departments—not welfare agencies. These agencies typically concentrate their efforts in low-income communities, but the missions and mechanisms involved do not

directly tie into welfare/job systems. Historically, pregnancy prevention has been

funded by the federal government under the Title X Family Planning Program and

public health and education laws to achieve reductions in infant mortality or high

school drop-out rates for pregnant and parenting teens.

Because political disagreements over how to prevent teen pregnancy—and thus

how to make connections between programs and program bureaucracies—are often

less strong within some communities than within whole states, most states have devolved pregnancy prevention functions downwards in connection with the 1996 welfare reform act. Teen pregnancy prevention shows the highest degree of secondorder devolution of four basic welfare-related service functions we examined. As

Table 1 demonstrates, state agencies perform a relatively weak role in managing

pregnancy prevention activities when compared to their roles in the administration

of cash assistance or employment and training services. In our research sample,

fewer than half of the state governments play an important role in delivering pregnancy prevention services, and only two out of three state governments exercise significant control over the administrative design of such programs. One out of four

states have no important policy-making function in this area. Even among the

states that retain significant control over policy, they often share that power with

a wide variety of local institutions, including local public health agencies, public

schools, and private nonprofit agencies.

This downward shift in program responsibility may reduce some obstacles, but it

creates others. Devolution down to localities may allow for greater flexibility and

community involvement, but it can also cut down the budget for such programs. For

example, Ohio tried to create a teen-pregnancy prevention bonus modeled after the

federal one and was unsuccessful. Despite the fact that there is a state-provided incentive payment for the top performing counties in reducing out-of-wedlock births,

we were told that Hamilton County (Cincinnati) ‘‘downplayed the minimal amount

of incentive money . . . people interviewed were doubtful that the county could do

much to affect out-of-wedlock pregnancy and stressed that the financial rewards are

too small for the county to expend much energy developing a program’’ (Ohio Field

Research Report, 1998).

Although site-specific actions in this policy area were not found to be widespread,

several field researchers did identify cases of connectivity of welfare/job and teen

pregnancy prevention efforts.

• In Washington State, welfare offices have family planning nurses on staff. Eight

of fifty welfare offices are co-located with a family planning clinic. While funding

has increased for family planning under TANF, these connections are not new.

• Florida has mapped out a long-term strategy that includes the implementation

of a statewide protocol for the referral of clients to family planning services. Eventually, steps are to be taken so that family planning services are integrated with work

44

activities. Currently, some WAGES (‘‘Work and Gain Economic Self Sufficiency’’)

coalitions have designated a staff member to coordinate pregnancy prevention programs within their region.

Table 1. Devolution Of Pregnancy Prevention Program Functions to Local Governments, Public Institutions,

and Private Agencies

[Percent of states indicating that various institutions perform a significant role in policy-making, administrative design, and service delivery for

pregnancy prevention, employment and training, and cash assistance programs]

Institution Pregnancy

Prevention

Employment

and Training

Cash

Assistance

Policy Making:

State government ........................................................ 74 100 100

Local government ........................................................ 27 26 21

Other public institutions ............................................ 32 16 0

Statewide nonprofits ................................................... 13 0 5

Local nonprofits .......................................................... 7 5 21

Administrative Design:

State government ........................................................ 63 95 95

Local government ........................................................ 21 32 37

Other public institutions ............................................ 32 21 0

Statewide nonprofits ................................................... 5 11 0

Local nonprofits .......................................................... 11 5 11

Service Delivery:

State government ........................................................ 42 74 58

Local government ........................................................ 53 47 37

Other public institutions ............................................ 47 74 0

Statewide nonprofits ................................................... 40 47 11

Local nonprofits .......................................................... 47 68 26

Source: Field Research Reports, State Capacity Study, 1998.

Note: Data from nineteen states are included in the table. ‘‘State government’’ includes local as well as central offices of state agencies. ‘‘Other public institutions’’ includes school districts, community colleges, public

hospitals, ans so on.

• In Georgia, as part of the eligibility process, family members identified as needing information regarding family planning are to be referred to services. The state

plan includes a list of personal responsibility requirements that may, for example,

include requiring family planning counseling as well as participation in parenting

classes for all teens whether or not they are parents. Recent controversy appears

to have dampened the early enthusiasm for implementing this requirement. Nevertheless, in Bibb County, Georgia, we found that a family planning clinic is located

just outside the welfare office and workers make frequent referrals. In Fulton County, Atlanta, one welfare office has on-site family planning services.

These examples are more the exception than the rule. The Rockefeller Institute

is continuing, and in fact accentuating, its local field observations, including a review of implementation activities in the pregnancy-prevention policy area for the

second round of field research on the implementation of welfare reforms.

CONCLUSION

At a conference last year at the American Enterprise Institute on teen pregnancy

prevention, Douglas Besherov, the convenor, summarized the overall situation by

citing ‘‘deep ambivalence’’ in this policy area. Jason Turner, Commissioner of the

New York City Human Resources Administration, who also spoke at this conference,

agreed, saying there is ‘‘lack of a consensus’’ not about whether to reduce teen pregnancy—but how. The dilemma is real: The popular culture incessantly signals a set

of permissive values about sexual behavior, while at the same time the political culture gives decidedly different and very strong signals about sexual abstinence and

family integrity.

STATE CAPACITY STUDY FIELD RESEARCH TEAM LEADERS

The Nelson A. Rockefeller Institute of Government

Arizona—John Stuart Hall, Arizona State University

California—Cristy A. Jensen, California State University

Florida—Robert E. Crew, Florida State University

Georgia—Michael J. Rich, Emory University

Kansas—Jocelyn M. Johnston, University of Kansas

45

Michigan—Carol S. Weissert, Michigan State University

Minnesota—Thomas F, Luce, University of Minnesota

Mississippi—David A. Breaux, Christopher M. Duncan, John C. Morris, Denise Keller, Mississippi State University

Missouri—Rockefeller Institute Central Staff

New Jersey—Richard F. Roper, The Roper Group Consultants

New York—Sarah F. Liebschutz, SUNY Brockport Distinguished Service Professor

North Carolina—Deil S. Wright, University of North Carolina

Ohio—Charles F, Adams, Jr., Ohio State University

Rhode Island—Thomas J. Anton, Brown University

Tennessee—John E. Gnuschke, University of Memphis

Texas—Christopher T. King, University of Texas at Austin

Utah—Gary C. Bryner, Brigham Young University

Washington—Betty Jane Narver, Janet Looney, University of Washington at Seattle

West Virginia—David G. Williams and L. Christopher Plein West Virginia University

Wisconsin—Thomas J. Corbett and Thomas J. Kaplan, University of Wisconsin, Poverty Institute

Chairman JOHNSON of Connecticut. Mr. Rector.

f STATEMENT OF ROBERT RECTOR, SENIOR POLICY ANALYST,

HERITAGE FOUNDATION

Mr. RECTOR. Thank you very much. I appreciate the opportunity

to be here and testify about out-of-wedlock childbearing today.

In 1950, about 4 percent of all children were born out of wedlock;

today, that number has risen to 32 percent. As we speak, one child

in the United States will be born out of wedlock every 35 seconds.

During the course of this hearing there will probably be about 300

children born out of wedlock. The initial Medicaid costs for the

births alone of those 300 children will be about a million dollars.

This is clearly the most important social problem facing our society today. The first point I would like to make is to emphasize the

very crucial difference between teen pregnancy and out-of-wedlock

childbearing. Only about 14 percent of the children born out of

wedlock in the United States today are born to girls under age 18.

In fact, there are more children born out of wedlock to women over

age 30, than there are to teenagers in high school. If you look in

my testimony, I give a table on this where I show that the predominant amount of out-of-wedlock childbearing occurs to young

women in their 19, 20, up to about age 24.

Women having children out of wedlock are mainly young adult

women. In 40 percent of the cases, they are actually cohabiting

with the adult male, the father of that child. Out-of-wedlock childbearing, the one-million-plus children born out of wedlock each

year is not a matter of high school students. It is, in fact, a crisis

in the enduring relationships between young adult men and women

in the United States, and it is very important that we recognize

that distinction.

Now, I wanted to talk briefly about some of the social effects of

out-of-wedlock childbearing. This is data from the National Longitudinal Survey of Youth. What we did was look at children’s status

at birth and look at the subsequent family structure for that child.

On the left, we have children that were born out of wedlock and

the mother never marries; and on the extreme right, we have children that are born inside marriage and the marriage remains inVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00049 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
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tact. The charts shows the poverty rates during the life of the child.

We find the child born outside of wedlock, where there never is a

marriage, was poor half of the child’s life. By contrast, the child

born inside an intact marriage, where the marriage remains stable,

is poor 7 percent of the time. So there is a 700 percent increase

in child poverty that is the direct result of out-of-wedlock childbearing.

If we could go to the next chart, we see the same sets of statistics. This chart refers to welfare dependence. The black column is

AFDC receipt. We find a child born outside of the wedlock, where

the mother never marries, received AFDC about 50 percent of the

time during this period of analysis.

By contrast, you go over to the right side of the chart, a child

born inside marriage where the marriage remains intact received

AFDC about 3 percent of the time. Again, you have got something

like—in that case, it is more than 1,000 percent increase, about a

2,000 percent increase in the rate of welfare dependence as a result

of out-of-wedlock childbearing.

Out-of-wedlock childbearing is the primary cause both of child

poverty and of welfare dependence in the United States today.

A further chart on crime was provided in written testimony, but

I don’t have a mock-up of it. We looked at incarceration in juvenile

facilities in the State of Wisconsin where we had very, very good

data. We found that roughly half of the children—these would be

teenagers—incarcerated in juvenile facilities in Wisconsin were

children born out of wedlock where the mother had never married.

Overall, the increase in probability that a child would commit

crimes and end up in jail, we found it 22 times higher among—for

a child that was born out of wedlock where the mother never marries, compared to a child born inside wedlock where the biological

mother and father have remained together in a stable marriage.

Out-of-wedlock childbearing and family instability is the principal cause of crime in the United States today.

Now, we could go on and begin to think about different policies

that we could establish to address this issue. I am going to emphasize two in my oral testimony. The first is abstinence education. I

would encourage the committee very strongly to look at a program

such as Best Friends in the District of Columbia, which appears to

reduce the sexual activity rates of inner city girls by about 80 percent. But beyond that, we need to go on and recognize that the goal

here is not just to get girls out of high school without getting pregnant. We want to go on and give them the vision and the skill necessary to form stable marital relationships when they are young

adults in their 20s and are going to begin having children.

So I would strongly urge expansion of abstinence education, combined with marriage education to emphasize the importance of

marriage in the lives of men, women and children.

The second policy that I think we should look at very strongly

is to recognize that when a woman has a child out of wedlock, society pays for that very heavily. For example, for about 75 percent

of the children born out of wedlock, Medicaid pays for the birth directly. We ought to look at policies, experiments to reward women

not for making mistakes in their lives, but for doing the right

thing. For example, we could take a group of at-risk women and

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say, if you get through high school and if your first birth is within

marriage, we will reward you for taking those steps in the proper

direction.

I can’t guarantee that that would work, but I would love to see

how individuals would respond to that.

In conclusion, I would say that out-of-wedlock childbearing is

clearly harmful to the child, to the mother, to the father and to society. The most important and pressing thing we can do is to communicate the value of marriage, and define policies that can successfully begin to rebuild marriage in our society.

Chairman JOHNSON of Connecticut. Thank you very much, Mr.

Rector.

[The prepared statement follows:]

Statement of Robert Rector, Senior Policy Analyst, Heritage Foundation

OUT-OF-WEDLOCK CHILDBEARING: TRENDS AND SOCIAL EFFECTS

INTRODUCTION

I wish to thank the Sub-Committee on Human Resources for the opportunity to

testify today. The views which I will express are my own and do not necessarily reflect the views of The Heritage Foundation.

For more than three decades in U.S. society, marriage has declined, illegitimacy

has flourished, and fathers have disappeared from the lives of children. The upward

surge in out-of-wedlock child bearing has been accompanied by a mushrooming of

other social problems: crime, welfare dependence, child abuse and drug abuse. The

collapse of marriage, rise of illegitimacy, and absence of fathers are the root cause

behind most of the nation’s social problems.

When the American War on Poverty began in 1965, 7 percent of America’s children were born out-of-wedlock, today nearly a third are. (See Chart 1.) As we speak,

one American child is born outside marriage every 25 seconds.

The rise in illegitimacy has been driven by three factors: (1) a decline in the portion of women of child bearing age who are married; (2) an increase in the birth

rate of non-married women; and (3) a decrease in the birth rate of married women.

(See Charts 2 and 3.)

As a result of these factors, the number of births to married women has declined

dramatically and is now at the lowest level since the end of World War II. During

the same period, out-of-wedlock births have increased 1,000 percent, rising from

125,000 in 1946 to 1.26 million in 1997.1 (See chart 4.)

The decline in marital births has been particularly severe among black Americans. Today the number of black children born within marriage is roughly half the

number at the end of World War II. This change is largely due to a precipitate drop

in the number of adult black women who marry.

RECENT GOOD NEWS

In nearly every year since the mid–1960s, the percentage of births that were outof-wedlock increased steadily. In the last few years, however, there has been modest

good news. In 1995, 1996, and 1997, there was a ‘‘pause’’ in the growth of illegitimacy, for the first time in three decades. (See Chart 1) The growth of the white

out-of-wedlock birth rate slowed considerably, and the black rate actually declined

slightly. This ‘‘pause’’ in the growth of illegitimacy (which coincided with the debate

and passage of national welfare reform in the United States) is of great social significance. The crucial question is whether this pause will continue. Will the share

of births which are outside marriage remain steady, or begin to fall? Or will illegitimacy soon resume its steady upward climb?

OUT-OF-WEDLOCK CHILDBEARING BY ETHNIC GROUP

Childbearing out-of-wedlock varies greatly between racial/ethnic groups. Chart 5

shows the percent of U.S. births that were out-of-wedlock in 1997 for five separate

ethnic groups. The highest rate was non-Hispanic blacks, among whom 69.4% of

births were out-of-wedlock. American Indians have the second highest rate at 58.7%,

followed by Hispanics at 40.92%. Among non-Hispanic whites, 21.54 percent of

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births are out of wedlock, and Asians/Pacific islanders have the lowest rate with

15.64% of births being out-of-wedlock.

While black Americans have the highest percentage of births that are out-of-wedlock—this does not mean that most children born out-of-wedlock in the U.S. are

black. In fact, only about one third of all out-of-wedlock births are to non-Hispanic

blacks.

Moreover, nearly all of the increase in illegitimacy occurring in recent years is due

to whites. Between 1980 and 1997, annual black non-marital births increased by

only about 100,000. By contrast, white out-of wedlock births more than doubled (rising from 328,984 to 793,202). In 1980 the numbers of black and white out-of-wedlock births were nearly equal; by 1997 there were almost two white out-of-wedlock

births for each black birth.

OUT-OF-WEDLOCK CHILDBEARING AND TEEN PREGNANCY

The rise of illegitimacy in the U.S. should not be confused with teenage pregnancy. Out-of-wedlock child bearing is overwhelmingly a problem among young

adult women (age 18 to 25), not minor teenage girls in high school. Only 13.17 percent of out-of-wedlock births occur to girls under 18. In fact, more out-of-wedlock

births occur to women age thirty and over, than to minor teenage girls. (See Chart

6.) Out-of-wedlock childbearing is not primarily the product of careless and haphazard behavior between sexually active high school students, instead it represents

a profound crisis in the relationships between young adult men and women.

OTHER SOCIAL FACTORS RELATING TO OUT-OF-WEDLOCK CHILDBEARING

The conventional image is that out-of-wedlock births are largely the result of accidental pregnancy. In fact, nearly half of all illegitimate births are the result of an

intended pregnancy; 34 percent are the result of a pregnancy that occurred earlier

than the mother wished and only 14 percent are the result of a pregnancy that was

completely unwanted. (See Chart 7)

There is a strong tendency toward repeat out-of-wedlock births. Roughly half of

all illegitimate births are not first births, but are second, third or even later births

to the mother. (See Chart 8.)

Most out-of-wedlock births do not occur as a result of ephemeral sexual encounters between near strangers. In fact, nearly forty percent of all out-of-wedlock births

occur to women who are cohabiting with an adult male, who in most cases is the

newborn’s father. (See Chart 9.) Regrettably, these cohabiting relationships are unstable and generally dissolve within a few years rather than evolving into marriage.

A key factor in determining whether a woman will have a child out-of-wedlock is

religious belief and practice. Regular church attendance cuts the probability of having a child out-of-wedlock roughly in half. (See Chart 10.)

SOCIAL EFFECTS OF THE RISE IN NON-MARITAL BIRTHS

The decline in marriage and the rise in out-of-wedlock childbearing has been associated with host of other social problems. In particular, the rise in illegitimacy has

been a primary factor contributing to increases in: child poverty; welfare dependence; behavioral and emotional problems; and crime. In addition, the decline in marriage has been associated with high numbers of abortions.

SOCIAL EFFECT #1: OUT-OF-WEDLOCK CHILDBEARING AND POVERTY

The most obvious consequence of the rising tide of illegitimacy and disappearance

of fathers is child poverty. Chart 11 shows data from the National Longitudinal Survey of Youth (NLSY) which contains a nationally representative sample of young

mothers and their children. The chart divides children into four groups:

1. Out-of-Wedlock-Never Married—Children born out of wedlock whose mother

has never married after the birth of the child;

2. Out-of-Wedlock-Subsequent Marriage—Children born out of wedlock whose

mother marries subsequent to the child’s birth;

3. Within Wedlock-Divorced—Children born to married parents who later divorce;

4. Within Wedlock-Marriage Intact—Children born to parents who were married

at the time of birth and remained married

The chart shows the amount of time since birth that a child has lived in poverty

for the four different categories of children. Children born out-of-wedlock to never

married women are poor fifty-one percent of the time. By contrast children born

within a marriage which remains intact are poor 7 percent of the time. Thus the

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1Deborah A. Dawson, ‘‘Family Structure and Children’s Health and Well-being: Data from the

1988 National Health Interview Survey on Child Health,’’ paper presented at the annual meeting of the Population Association of America, Toronto, May 1990. 2 E.M. Hetherington and B. Martin, ‘‘Family Interaction,’’ in H.C. Quay and J.S. Werry (eds.),

Psychopathological Disorders of Childhood (New York: John Wiley & Sons, 1979), pp. 247–302. 3 A. Walsh, ‘‘Illegitimacy, Child-Abuse and Neglect, and Cognitive Development,’’ Journal of

Genetic Psychology, Vol. 15 (1990), pp. 279–285.

absence of marriage increases the frequency of child poverty 700 percent. However,

marriage after an illegitimate birth cuts the child poverty rate in half.

SOCIAL EFFECT #2: OUT-OF-WEDLOCK CHILDBEARING AND DEPENDENCE

A second consequence of father absence and out-of-wedlock births is prolonged

welfare dependence. Chart 12, using data from the NLSY, separates children into

the same four groups as the previous chart on poverty. Children born out-of-wedlock

whose mothers have not married have received Aid to Families with Dependent

Children (AFDC) benefits for fifty percent of the time since birth. By contrast, children who were born in wedlock and whose parents have remained married have received AFDC only 3 percent of the time since birth. Thus AFDC receipt is 1700 percent more frequent among illegitimate children of never married mothers than

among legitimate children raised by intact married couples.

If a woman gives birth out-of-wedlock but subsequently marries, the average

length of time spent on AFDC will be cut in half, falling from 50 percent (for children of never married mothers) to 23 percent. Marriage even after an out-of-wedlock

birth is thus quite effective in reducing dependence. Conversely if the parents of a

legitimate child divorce, the length of time on AFDC will rise from 3 percent (for

intact married couples) to 13 percent for divorced families.

Chart 12 also shows the portion of time which children in the four different categories received any of the following means-tested welfare benefits: AFDC, Food

Stamps, Medicaid, SSI, and WIC. On average, children in the ‘‘out-of-wedlock-never

married’’ group received some form of welfare benefit for 71 percent of the months

since birth. By contrast, legitimate children whose parents remained married have

received some welfare for 12 percent of the time. Welfare receipt is six times greater

among the never-married group.

SOCIAL EFFECT #3: OUT-OF-WEDLOCK CHILDBEARING AND EMOTIONAL AND

BEHAVIORAL PROBLEMS

Data from the National Health Interview Survey of Child Health (NHIS-CH) confirm that children born out of wedlock have far more behavioral and emotional problems than do children in intact married families. These problems include:

Antisocial behavior—disobedience in school, cheating and lying; bullying and cruelty to others; breaking things deliberately; failure to feel sorry after misbehaving;

Hyperactive behavior—difficulty concentrating or paying attention; becoming easily confused; acting without thinking; being restless or overactive;

Headstrong behavior—easily losing one’s temper; being stubborn, irritable, disobedient at home; arguing excessively;

Peer conflict—having trouble getting along with others, being not liked, being

withdrawn;

Dependent behavior—crying too much, being too dependent on others, demanding

attention, clinging to adults.

Children raised by never-married mothers have significantly higher levels of all

of the above behavior problems when compared to children raised by both biological

parents. When comparisons are made between families that are identical in race,

income, number of children, and mother’s education, the behavioral differences between illegitimate and legitimate children actually widen. Compared to children living with both biological parents in similar socioeconomic circumstances, children of

never-married mothers exhibit 68 percent more antisocial behavior, 24 percent more

headstrong behavior, 33 percent more hyperactive behavior, 78 percent more peer

conflict, and 53 percent more dependency. (See Chart 13.) Overall, children of nevermarried mothers have behavioral problems that score nearly three times higher

than children raised in comparable intact families.1

In addition, children born out of wedlock have less ability to delay gratification

and poorer impulse control (control over anger and sexual gratification). They have

a weaker sense of conscience or sense of right and wrong.2 Adding to all this is the

sad fact that the incidence of child abuse and neglect is higher among single-parent

families.3

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4See Robert Rector and Patrick F. Fagan, ‘‘How Welfare Harms Kids,’’ The Heritage Foundation Backgrounder, No. 1084, June 5, 1996. 5M. Anne Hill and June O’Neill, Underclass Behaviors in the United States: Measurement

and Analysis of Determinants, New York City, City University of New York, Baruch College

March 1990. 6Wisconsin Department of Health and Social Services, Division of Youth Services, Family Status of Delinquents in Juvenile Correctional Facilities in Wisconsin, April 1994. 7General figures on Wisconsin teenagers are from a Heritage Foundation calculation based

on the public use sample of the 1990 Census. The overall statewide percentage of Wisconsin

teenage children residing with two married biological parents was adjusted downward to compensate for the underreporting of step child status in the Census data. 8 Based on data provided by Pat Fagan. Due to limitations in the Census data on Wisconsin

youth in general these figures should be interpreted as rough probabilities rather than precise

estimates. 9Stanley K. Henshaw, ‘‘Unintended Pregnancy in the United States’’ Family Planning Perspectives, January/February 1998. 10 Ibid.

Being born out-of-wedlock and growing up in a single-parent family means the

child is more likely to experience: retarded cognitive (especially verbal) development;

lower educational achievement; lower job attainment; increased behavior and emotional problems; lower impulse control; and retarded social development. Such children are far more likely to: engage in early sexual activity; have children out of

wedlock; be on welfare as adults; and engage in criminal activity.4

SOCIAL EFFECT #4: OUT-OF-WEDLOCK CHILDBEARING AND CRIME

Research by former Congressional Budget Office Director Dr. June O’Neill demonstrates the clear linkage between crime and single-parent families. Using data

from the National Longitudinal Survey of Youth, O’Neill found that young black

men raised in single-parent families were twice as likely to engage in criminal activities when compared to black men raised in two-parent families, even after holding constant a wide range of variables such as family income, urban residence,

neighborhood environment, and parents’ education. Growing up in a single-parent

family in a neighborhood with many other single-parent families on welfare triples

the probability that a young black man will engage in criminal activity.5

Even stronger evidence is provided by a study of the family backgrounds of youths

incarcerated in juvenile correctional jails in Wisconsin in 1993.6 As Chart 14 shows,

only 13 percent of the juvenile offenders came from married couples where the

child’s biological father and mother were currently married and living together. In

other words 87 percent of the juvenile criminals in Wisconsin came from never married or broken homes.

The report clearly demonstrates, not only that most juvenile crime is performed

by youth from splintered homes, but that such children are far more likely to commit crimes than are those from homes with intact marriages. While only 13 percent

of incarcerated offenders were from married couple homes with two biological parents, United States Census data shows that roughly half of Wisconsin teenagers actually lived in such intact married families in 1990.7

Chart 15 shows the comparative probability of juvenile incarceration based on

family structure. A child living with a never-married family was more than 22 times

likely to be incarcerated for criminal activities than is a youth raised by married

biological parents. Children from divorced, separated, and widowed families were

some three times to be incarcerated for criminal activity than was a child from an

intact married family with both biological parents.8

SOCIAL EFFECT #5: THE DECLINE IN MARRIAGE AND ABORTION

Abortion in America is profoundly linked to the sharp decline in marriage and the

increase in non-marital sexual activity outside of marriage. About 5.5 million pregnancies occur in the U.S. each year; nearly half (44 percent) of these pregnancies

are to non-married women.9 Surprisingly, the pregnancy rate among never married

women is virtually the same as for married women. In 1994 there were 95 pregnancies per thousand married women age 15 to 44. Among never-married women

the rate was 91 pregnancies per thousand.

However, while married and non-married women have similar pregnancy rates,

they differ greatly in whether a pregnancy is carried forward to childbirth. Nearly

half of all pregnancies among non-married women end in abortions. By contrast,

only 11 percent of pregnancies among married women end in abortion.10 (See Chart

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11 Ibid. p. 26 12 Using state level data the correlation between the number of illegitimate births per 1,000

women aged 15–44 and number of abortions per 1,000 women aged 15–44 ranges from +.67 to

+.72. See Robert Rector, ‘‘The Fallacy that Welfare Reform Will Increase Abortions,’’ The Heritage Foundation Executive Memorandum, No.407, March 21, 1995. 13 A rule against cohabitation by welfare mothers could be used, but it would be difficult to

enforce and might only push ‘‘Bill’’ from the home. 14Traditional welfare programs also create a strong incentive for the mother not to work or

to hide her earnings from the government.

16.) Overall, three quarters of abortions in the U.S. are performed on non-married

women.11

Some believe there may be a trade off between abortion and out-of-wedlock childbearing, maintaining that abortion may be decreased by increasing illegitimate

births or vice versa. The facts do not support this view. In reality, those states with

high abortion rates also have a higher rates of out-of-wedlock childbearing.12 This

is because both illegitimacy and abortion stem from a common source: the decline

in marriage. Therefore policies which would strengthen marriage in our society

would have a double effect of reducing both out-of wedlock childbearing and abortion.

OUT-OF-WEDLOCK BIRTHS, MARRIAGE, AND WELFARE

The decline of fatherhood and marriage has been tied to the growth of the welfare

state and is inherent in the structure government welfare programs. Welfare programs are programs which are ‘‘means-tested’’ or ‘‘income-limited:’’ this means that

benefits from a welfare program are restricted to households whose non-welfare income falls below a certain limit. This restriction may take the form of an abrupt

termination of eligibility when non-welfare income reaches a specified level, but is

more likely to take the form of a graduated schedule in which benefits are incrementally reduced as non-welfare income rises.

In the United States, there are over 70 major income-tested welfare programs.

These provide cash, food, housing, medical care and targeted social services to low

income persons. Federal and state spending on these programs costs over $400 billion per year or 5 percent of the U.S. Gross Domestic Product. About half of this

welfare spending is directed to families with children.

It is critical to understand that all means-tested welfare programs are inherently

anti-marriage and produce what has been termed ‘‘household splitting effects.’’ This

occurs because welfare benefits fall as household earnings rise; welfare can thus be

maximized by removing an employed father from the home or taking steps to ensure

his earnings are formally disregarded by the welfare system.

To understand how this process works in the U.S., we can imagine an example:

‘‘Annie,’’ a mother, and ‘‘Bill,’’ the employed father of her children. If Annie and Bill

are not married and merely cohabit, Bill’s earnings will generally be disregarded by

the government and Annie will receive a variety of welfare benefits. If, on the other

hand, Annie and Bill get married, Bill’s earnings will immediately count against

Annie’s welfare eligibility and her benefits will be terminated or substantially reduced.13

There are various permutations on this principle, but the underlying rule is always the same: if a mother and father present themselves as two separate legal

units to the government, they will usually be able to draw on two sources of income,

welfare and the father’s earnings. If, however, the mother and father are a married

couple, they will receive, in general, only one source of income, the father’s earnings.

It is crucial to understand that this is not a small accident in the welfare system,

but is the inevitable result of the nature of ‘‘means-tested’’ welfare. Such welfare

programs are inherently biased not against marriage, per se, but against the earnings of an employed husband.14 Earnings jeopardize welfare income; welfare benefits will be maximized only if the husband does not work, or if the father and mother are not married.

The very structure of welfare programs thus implicitly penalizes married couples

with an employed husband with a low or moderate income. The only way to eliminate this bias would be to universalize all means-tested benefits currently targeted

toward single mothers. Under a universalized system, all mothers would receive the

same benefits irrespective of marital status and irrespective of their husband’s earnings level. Under such a hypothetical system, no mother would suffer a reduction

in welfare because she was married to a working husband.

Such a universal benefit system would be extraordinarily expensive. Moreover,

even in such a system, anti-marriage effects would remain. The presence of generous universal supports to all mothers would undermine the economic necessity of

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marriage, rendering husbands’ earnings less necessary or even superfluous. This

would be particularly true for low wage, low skill fathers, precisely the group for

whom marriage has become the most tenuous.

PROVISIONS RELATING TO MARRIAGE AND ILLEGITIMACY IN THE 1996

WELFARE REFORM

The Personal Responsibility and Work Opportunity Reconciliation Act enacted in

1996 contained several key provisions designed to strengthen marriage and reduce

illegitimacy.

(1) The law established for the first time in the nation’s history, a clear goal to

‘‘prevent and reduce the incidence of out-of wedlock pregnancies.’’

(2) It required states to establish annual numerical goals for reducing out-of-wedlock childbearing. (3) It created an illegitimacy ratio reduction bonus fund of $50 million per year

to reward states which decrease the percentage of births which occur outside of marriage without increasing abortions. Up to five states may receive funds each year

under this provision.

(4) It created a new program to provide abstinence education directed toward mar- riage with funding of $50 million per year.

Finally, during the national debate on welfare reform running from 1994 through

1996, Congress for the first time in the nation’s history engaged in a clear and forthright debate concerning the societal harm caused by illegitimacy and the linkage between welfare and out-of-wedlock childbearing. This debate broke a spell of silence

which had prevailed on this issue for more than three decades.

For the first time, the majority of the members of both parties were clear in affirming both the harm of illegitimacy, and the desirability of strengthening marriage. During this period, press coverage on the harmful effects of illegitimacy on

children and society increased tenfold. The clear public discourse on the value of

marriage and ills associated with out-of wedlock childbearing—reinforced by the underlying theme of personal responsibility embodied in reform legislation—played a

critical role in the unexpected halt in the growth of illegitimacy which began in

1995.

NEW POLICY DIRECTIONS

Since most other social problems stem from or are closely associated with the dramatic decline in marriage, the restoration of marriage must be our top social priority. Given the anti-marriage bias inherent in means-tested programs, it will be

very difficult to eliminate the all anti-marriage effects from our welfare system. But

this does not mean that positive steps to strengthen and promote marriage cannot

be taken. Such positive steps would include:

1. Constantly Articulate the Goal of Marriage.—The death of marriage is the central social problem facing our society. The first step in restoring marriage would be

for social and political leaders to forcefully provide the message that marriage is essential to the welfare of men, women and children, and that bearing and raising

children out-of wedlock is undesirable for both the child and society.

2. Provide Abstinence and Marriage Education.—Young people should be educated

about the crucial linkage between marriage, human happiness, and social wellbeing. (This message is completely absent in our schools.) They should be instructed

in the value of abstaining from sexual activity until marriage, and should be taught

the inter-personal skills needed to build strong and committed relationships between men and women.

3. Increase the Illegitimacy Reduction Bonus Fund.—As noted, the 1996 welfare

reform law created a pool of money to reward states which decrease out-of-wedlock

childbearing without increasing abortion. Funding for this program should be increased and awards should be made available to more than five states.

4. Establish Mentoring and Counseling Programs to Expand and Strengthen Marriage.—Marriage development and protection programs should be established in

communities with a high level of out-of wedlock child bearing and low levels of marriage. The inclusion of community and religious groups in such efforts would be critical. Such programs should include: mentoring programs to help restore role models

of successful marriage in communities where marriage has greatly eroded; counseling programs to instill the goal of successful marriage and to develop relationship

skills among at-risk men and women; and support programs to strengthen fragile

new marriages.

5. Limit Subsidization of Single Parenthood.—Welfare subsidies serve as a competition to marriage and undermine the importance of moderate-skilled men as

breadwinners and husbands. Limitations should be placed on traditional welfare

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subsidies to single parents; these would include policies such as work requirements

and providing loans rather than grants.

6. Reward Marriage Among At-Risk Groups.—New programs should be devised

which communicate social and governmental affirmation of marriage, and which explicitly reward the initiation and continuance of marriage by at-risk individuals.

CONCLUSION

The 1996 welfare reform act stated correctly that ‘‘marriage is the foundation of

a successful society.’’ The decline in marriage and the growth in out-of-wedlock

childbearing is injurious to the well-being of children, mothers, fathers and society

at large. No task is more important or pressing than the restoration and strengthening of marriage in our society.

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to welcome you back.

Chairman JOHNSON of Connecticut. Ms. Sawhill, it is a pleasure

f

STATEMENT OF ISABEL V. SAWHILL, PH.D., SENIOR FELLOW,

BROOKINGS INSTITUTION, AND PRESIDENT, NATIONAL CAMPAIGN TO PREVENT TEEN PREGNANCY

Ms. SAWHILL. Thank you very much, Madam Chair. I am really

delighted to be here.

The first question I want to raise is, why should we care about

nonmarital childbearing. Here I simply want to stress that all of

our research suggests that children are better off in two-parent

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than in one-parent families. They do better in school; they have

fewer behavioral and social problems. Even after you adjust for economic differences between two-parent and one-parent families, the

children in one-parent families are worse off.

However, the biggest problem is that children in single-parent

families have much lower incomes than those in two-parent families, as I show in figure 1.

The poverty rate amongst the children of never-married mothers

is six times as high as the poverty rate in two-parent families, and

this relationship holds no matter what racial or ethnic group you

are looking at.

Given the enormous differences in the economic situation of

these different types of families, it is not too surprising that given

the growth of both nonmarital childbearing and single-parent families, that we have experienced an upward trend in child poverty

rates since about 1970. The main factor that is driving the increase

in single-parent families in the last decade or so has been nonmarital childbearing. It used to be divorce that was driving the growth

of single-parent families; it isn’t anymore. The divorce rate has leveled off. So, it is now nonmarital childbearing that is driving up the

number of single-parent families, and it is the growth in single-parent families, in turn, that is responsible for much of the increase

in child poverty, as you can see in figure 2 where we have adjusted

the poverty rates for changes in family structure. We asked what

would the poverty rate amongst children be in 1996 if we still had

the same family structures that we did back in 1970; and the answer is, there wouldn’t be much more child poverty now than there

was in that earlier year.

Now, all of this is by way of saying that marriage is a powerful

antipoverty strategy, but many people say, ‘‘Well, the reason that

marriage has collapsed is because men don’t have the earnings and

the employment that they used to, particularly less-skilled, lesseducated men, and therefore, men and women aren’t getting married.’’ There is no sense in taking on a husband if that husband

can’t earn enough to support a family; and there is a little evidence

that declining earnings among men has played some role, but I

don’t think it has played the dominant role.

And to further reinforce the point that marriage is a good antipoverty device, in figure 3, I compare two families. One is a singleparent family with two children, working in a minimum wage job

full-time, and the second is a married couple in which both parents

are also working full-time at minimum-wage jobs. In both cases,

they get the Earned Income Tax Credit, although a little less EITC

in the second case than in the first. But as you can see very clearly,

this second family is economically much better off, even though neither of the parents is earning very much.

We haven’t taken into account child care costs here, which

changes the picture somewhat, and we can go into that later if you

like.

I think both Robert Rector and Stephanie Ventura made the

point that not all out-of-wedlock or nonmarital births are to teenagers, and that is true, but I want to emphasize that half of first

nonmarital births are to teenagers and that those births are overwhelmingly unplanned and unintended. In fact, about one-fifth of

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all teenage girls in the United States can be predicted to have a

child out of wedlock given current rates.

So I think that when it gets to the question of what can be done,

a very good place to focus our efforts is on reducing teenage pregnancies for several reasons. First, that is where the pattern of outof-wedlock childbearing starts; second, that is the group for whom

the consequences are most devastating, and third, that is the group

for which the greatest social consensus exists that something needs

to be done. You are going to hear more from Brenda Miller, my colleague at the National Campaign to Prevent Teen Pregnancy,

about the strategy that we have adopted at the National Campaign

for reducing teenage pregnancy. But one of the reasons that I got

involved in helping to found the National Campaign to Prevent

Teen Pregnancy is because I felt that reducing teenage pregnancies

was one of the most highly leveraged and important things we

could do to reduce poverty, welfare dependency and a whole host

of social problems that several people have already alluded to.

The good news is that teen pregnancy and birthrates have been

declining since the early 1990s, but bear in mind that we still have

rates that are much higher than in any other industrialized country. I am talking about five or six times as high as in Europe.

On this question of abstinence versus contraception, it is very divisive. There is a huge debate out there, as Dr. Nathan has suggested. This is one reason why it has been so difficult to move forward at the local level. We have done polling data on this, and our

polling data suggests that there is a strong, indeed, I would say,

an overwhelming, consensus in the country that we should promote

abstinence amongst school-age youth, but the public does not want

contraceptives to be taken away. They want to have them available

as a backup.

So, as I think you said, Madam Chair, we need a more balanced

conversation about this. We need abstinence to be our first message, but we need to have contraceptives available for those who

need them.

I could go on and make a number of other recommendations, but

in the interest of time and seeing the red light, I will leave it at

that for now. Thank you.

[The prepared statement follows:]

Statement of Isabel V. Sawhill, Ph.D., Senior Fellow, Brookings Institution,

and President, National Campaign to Prevent Teen Pregnancy

I appreciate the opportunity to testify on this important topic. Both as President

of the National Campaign to Prevent Teen Pregnancy and as a Senior Fellow at the

Brookings Institution, I have become convinced that early out-of-wedlock childbearing is bad for parents, bad for society, and especially bad for the children born

into such families. However, the views I express today are my own and should not

be attributed to a particular institution with which I am associated.

Three years after the enactment of welfare reform, the new law is being hailed

as a great success. Caseloads have declined dramatically since the law was signed,

and with fewer individuals to support, the states are flush with money. A strong

economy interacting with tougher welfare rules and more support for the working

poor is helping to turn welfare checks into paychecks. But the welfare system is like

a revolving door. In good times, more people move off the rolls than come on and

caseloads decline. But in bad times, exactly the reverse can occur. The only way to

permanently reduce poverty and its associated expense is to stem the longer-term

trends in out-of-wedlock childbearing that have historically pushed child poverty

and caseloads up. Unless the states invest their surplus funds in programs aimed

at preventing poverty, success may be short-lived or purchased at the expense of the

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children it was designed to help. If every recipient who finds a job is replaced by

a younger sister ill-prepared to support a family, the immutability of the revolving

door will once again prevail.

There are many ways of preventing poverty. We could invest in early childhood

education, inner city schools, or in additional supports for the working poor. But unless we can reduce out-of-wedlock pregnancies and encourage the formation of twoparent families, other efforts, by themselves, may well fail.

Much more attention needs to be given to encouraging young people to defer childbearing until they are ready to be parents. Some of the funds freed up by the drop

in caseloads ought to be invested in teen pregnancy prevention programs and in reconnecting fathers with their children. In the absence of such efforts, welfare reform’s current success is likely to be short-lived.

FAMILY STRUCTURE AND WELFARE DEPENDENCY

Rising divorce rates combined with a huge increase in childbearing outside of

marriage have led to a situation in which most children born today will spend some

time in a single parent family. And since roughly half of these single parents are

poor (Figure 1), large numbers of children are growing up in poverty as well. Indeed,

the growth of single parent families can account for virtually all of the increase in

child poverty since 1970 (Figure 2).

The growth of female-headed families has also contributed to the growth of the

welfare rolls. According to the Congressional Budget Office, welfare caseloads would

have declined considerably throughout most of the 1980s if it had not been for the

fact that the growth of single parent families continued to push them upwards.

Moreover, this factor was more than twice as important as the economy in accounting for the roughly one million increase in the basic caseload between 1989 and

1993.

It is not just the growth of female-headed families but also shifts in the composition of the group that have contributed to greater poverty and welfare dependency.

In the 1960s and 1970s, most of the growth of single parent families was caused

by increases in divorce or separation. In the 1980s and 1990s, all of the increase

has been driven by out-of-wedlock childbearing. Currently, 32 percent of all children

in the United States and more than half in many large cities are born outside of

marriage. Unmarried mothers tend to be younger and more disadvantaged than

their divorced counterparts. They are overwhelmingly poor (Figure 1) and about

three-quarters of them end up on welfare.

A large fraction of babies born outside of marriage have mothers who are not

teenagers. However, the pattern of out-of-wedlock childbearing is often established

at a young age. Specifically, more than half of first out-of-wedlock births are to

teens. So if we want to reduce such births and the welfare dependency that usually

ensues, the adolescent years are a good place to start.

There are two strategies that can be used to reduce teen, out-of-wedlock births.

One is to encourage marriage. The other is to discourage sex, pregnancy, and births

among teens. This latter strategy has the advantage of being more consistent with

the growing requirements of the economy for workers with higher levels of education and with evidence that teenage marriages are highly unstable.

OUT-OF-WEDLOCK CHILDBEARING: CAUSE OR SYMPTOM OF POVERTY?

Some contend that many of the women who have babies as unmarried teens

would have ended up poor and on welfare even if they had married and delayed

childbearing. The argument is that they come from disadvantaged families and

neighborhoods, have gone to poor schools, or faced other adverse influences that

make having a baby at a young age as good an option as any other. There are few

men with jobs for them to marry, and given their own lack of skills, welfare seems

like a relatively good alternative. Moreover, earnings for less skilled men have

plummeted over the past 30 years.

Although such arguments cannot be dismissed entirely, they are only a small part

of the story. To begin with, the drop in marriage rates, which has been especially

pronounced among African Americans, has been much larger than any economic

model can explain. Second, early childbearers are much less likely to complete high

school, leading directly to poor long-term employment prospects for the young

women involved. The children in such families suffer even greater adverse consequences, including poorer health, less success in school, and more behavior problems. Finally, the argument that declining earnings has made marriage less viable

is a curious one. Two adults can live more cheaply than one, and by pooling whatever earnings can be secured from even intermittent or low paid employment, they

will be better off than a single adult living alone. These arguments are doubly true

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once a child enters the picture and one parent either needs to stay home or shoulder

the extra expense of paying for child care.

One can grant that the earnings prospects of poorly educated, inner city residents

are not good and have deteriorated in recent decades, and that better schools and

more support systems for low-income working families would help. Still, early outof-wedlock childbearing greatly compounds the problem. Even well-educated individuals in their twenties have difficulty living on one income these days, and most middle class families have two earners. Yet, for some reason, it is assumed that if the

men in low-income communities can’t command a decent wage, they are not marriageable. But fathers are, or should be, more than just a meal ticket. And although

two minimum wage jobs will not make anyone rich, they will provide an income of

about $20,000 a year, well above the poverty level for a family with two children

(Figure 3). In short, marriage and delayed childbearing have the potential to solve

a lot of problems, including assuring a better future for the next generation.

WHY ARE TEEN PREGNANCY AND OUT-OF-WEDLOCK BIRTH RATES SO HIGH?

As teen pregnancy and childbearing have become more common, they have also

become more acceptable, or at least less stigmatized. A few decades ago, there were

real social penalties to be paid if a girl became pregnant outside of marriage. Young

girls refrained from sex for fear of becoming pregnant and being socially ostracized.

Among those who did get pregnant, shotgun marriages were common. Young men

had to compete for women’s affections by promising marriage or at least commitment. All of this changed during the 1970s and 1980s. Contraception and abortion

became much more available, women became more liberated, and sexual mores

changed dramatically. A study by George Akerlof and Janet Yellen documents how

the decline in shotgun marriages contributed to a rising tide of out-of-wedlock

births. But this same change in sexual mores led not just to fewer marriages but

also to a lot more sexual activity and a rising pregnancy rate among the nation’s

youth.

As Figure 4 shows, teen pregnancy rates increased from the early 1970s until

1990 and have been declining since that time. The relatively modest growth depicted in the chart is the result of two offsetting trends since 1972: increased sexual

activity among teens combined with greater use of contraception. If teens had not

increased their use of contraception over this period, teen pregnancy rates would

have soared and been almost 40 percent higher by now. On the other hand, contraceptive use did not keep pace with the greater tendency of teens to engage in sex,

with the result that, up until recently, the pregnancy rate kept rising. In the war

between sex and safer sex, sex won.

These increases in pregnancy rates have not always translated into higher birth

rates. The greater availability of abortion after 1973 kept the teen birthrate somewhat in check. But few people, whatever their position on this difficult issue, want

abortion to be the major means of preventing poverty and welfare dependency.

THE GOOD NEWS: TEEN PREGNANCY AND BIRTH RATES ARE NOW DECLINING

In the 1990s, teenage sexual activity stopped increasing or even declined a bit.

This combined with greater utilization of contraception among teens has caused the

teen pregnancy rate to decline for the first time in decades. Teen births have fallen

as well and the proportion of all children born out-of-wedlock has stabilized. The

drop in birth rates among unmarried black teens is especially striking. It has declined by almost one fifth since 1991, a much sharper drop than that experienced

by any other group.

What has caused this recent turnaround in sexual activity, pregnancy, and outof-wedlock births? No one really knows but there are several possible explanations.

One is fear of AIDS, which is widely suspected to be the most important reason for

teens’ willingness to either abstain from sex or use contraception more frequently

than in the past.

Another possible explanation is welfare reform itself. Although the trends predate

welfare reform, they may have gotten an extra push from the debate leading up to

enactment of the new law in 1996 and the state reforms that preceded it. Most researchers don’t expect welfare reform to have a big impact on out-of-wedlock childbearing. (Past studies are somewhat inconsistent, but most find that welfare has

had only minor effects.) However, the new law makes welfare, and thus unwed

motherhood, as a life choice much more difficult. And past research may not be a

very good guide to future behavior because it has been based on variations in welfare benefits across states, not system-wide changes that are accompanied by time

limits and strong moral messages that have the potential to change community

norms.

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Another factor that can’t be dismissed is the performance of the economy over this

period. The unemployment rate peaked in 1992 at 7.5 percent and has fallen sharply since. The long and very robust expansion, combined with increases in the minimum wage and in the Earned Income Tax Credit, may have helped to make work

more attractive than welfare, and provided young women with more of a reason to

defer childbearing. (This explanation is consistent with a surprisingly steep rise in

the labor force participation of less educated single mothers since 1990.) And finally,

tougher enforcement of child support laws may have made young men think twice

before producing a baby.

GIVEN ALL THIS GOOD NEWS, WHY WORRY?

Although recent declines auger well for the future, it is worth remembering that

teenage pregnancy rates are still at least twice as high as in other industrialized

countries and higher than they were in the early 1970s. About half of these pregnancies are carried to term while the remainder either end with a miscarriage or

are terminated by an abortion. Very few teen mothers put their babies up for adoption, or marry the baby’s father, a marked departure from practices 30 or 40 years

ago.

All of these considerations suggest that unless welfare reform begins to modify the

underlying demographic trends that contribute to poverty and welfare dependency,

it may do little more than reshuffle poor mothers and their children between welfare and low-paid work or worse. With the help of a strong economy, states could

end up being quite successful at moving existing recipients off the welfare rolls. But

unless they also focus on the number coming in the front door of the welfare system,

this could be a hollow victory. Congress has created an incentive for states to reduce

teen and out-of-wedlock childbearing by offering a bonus of $20 million annually to

the most successful states, and this has served as a wake-up call for some governors. But as Richard Nathan at SUNY Albany reports, many states have been reluctant to address the issue, considering it too hot to handle. They have tossed this

political hot potato to local governments and nonprofit organizations.

WHAT ELSE CAN BE DONE?

Efforts to reduce teen pregnancy have traditionally centered on sex education and

family planning services. Sex education, although widely available, is often too little

and too late to have much impact. The best curricula focus less on reproductive biology than on teaching adolescents the skills needed to handle relationships, resist

peer pressures, and negotiate difficult situations. Although teens are using contraception much more frequently than in the past, and their preferred method—

condoms—is widely available in stores, they do not typically use it consistently, especially when they are young. The result is that failure rates are high and unplanned pregnancies all too common. Even a 12 percent annual failure rate, typical

for condom users, cumulates to an almost certain pregnancy in the dozen years between puberty and marriage or an adult job. Part of the problem is that the boys

and young men involved are not held accountable for their actions. Although the

new welfare law puts considerable emphasis on establishing paternity and collecting

child support from fathers, up until now, most have had a free ride. Unwed fathers

need to be offered the same work opportunities and be subjected to the same requirements as the mothers of their children. And if Congress wants to do something

about the so-called ‘‘marriage penalty,’’ the place to start is with the Earned Income

Tax Credit (EITC). As a result of the credit, a working single parent with two children can qualify for almost $4,000 a year. But if she marries another low-wage

earner, she stands to lose most or all of these benefits. Congress should consider

basing the credit on individual rather than family earnings. (A requirement that

couples split their total earnings before the credit rate was applied would prevent

benefits from going to higher income families.) Under such a revised EITC, incentives to marry would be greatly enhanced.

In the meantime, efforts to equip adolescents with the knowledge and the means

to avoid pregnancy in the first place have been highly charged politically and have

created a backlash by conservatives, and even by some moderates, who want more

emphasis placed on abstinence. Public opinion polls show that over 90 percent of

the public believes that abstinence is the appropriate standard for school-age youth,

even though a majority still wants contraceptives to be available as a backup. (Contrary to what some believe, there is no evidence that teaching young people how to

protect themselves causes them to have more sex.) As part of the 1996 welfare reform bill, Congress provided $50 million a year for abstinence education programs.

Such programs have never been adequately evaluated and many experts are skeptical that ‘‘just say no’’ campaigns by themselves will have much effect. But there

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is newfound appreciation for the need to encourage abstinence, especially among

younger teens. In addition, if these or other funds were used for programs such as

mentoring, community service, or after school activities, it could make a difference.

Those looking for guaranteed programmatic solutions to this problem are likely

to be disappointed. The point is not that programs can’t be effective, but that in isolation from a change in social norms, their impact may be small. Conversely, an

intervention that begins by affecting behavior in quite modest ways may eventually

produce changes in norms that snowball into bigger long-term effects. Behavior is

contagious. Teens, in particular, are enormously influenced by what their friends,

parents, and heros say and do, as documented in research commissioned by the National Campaign to Prevent Teen Pregnancy. This suggests that programs not be

judged only on the basis of their immediate effects but also on their potential to reengage parents and reorient peer culture. It also suggests devoting some funds to

media campaigns and to support for community or youth-led efforts that focus on

values and not just services.

In conclusion, reducing teen pregnancy could substantially decrease child poverty,

welfare dependency, and other social ills. Although little is known with certainty

about how to advance this objective, states now have the opportunity to experiment

with a variety of promising approaches that are critical to the longer-term success

of current welfare reform efforts. Whatever approach states choose, they should remain cognizant of the importance of strengthening the social norm that teen outof-wedlock childbearing is—to put it most simply—wrong.

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I am going to need to leave because I am going to be in a panel

Mr. CARDIN. Madam Chair, if I can interrupt for just a moment,

f

testifying before another committee, taking your place, on a pension bill. I apologize, but I need to testify before another legislative

committee at this time, and I look forward to reading the testimony

of those that I do not hear today, and working with everybody here.

Chairman JOHNSON of Connecticut. Thank you. I have to say the

bill that Ben and my colleague, Rob Portman, are proposing will

have as much to do with helping to create economic security for

some of these young girls as anything this Congress might do by

allowing and encouraging employers, even those who provide minVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00081 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
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imum wage benefits to their employees, to also be able to provide

pension opportunities and encourage savings.

Thanks, Ben.

Pat Funderburk.

STATEMENT OF PAT FUNDERBURK WARE, PRESIDENT AND

CHIEF EXECUTIVE OFFICER, PRESERVING FAMILY WELLBEING FOUNDATION, ASHBURN, VIRGINIA

Ms. WARE. Good morning.

Chairman JOHNSON of Connecticut. I’m sorry, Pat Ware.

Ms. WARE. Pat Funderburk Ware, but it is not hyphenated, and

Ware is so much easier than Funderburk, so I just use the Ware.

I am now serving as president and CEO of Preserving Family

Well-Being Foundation, a new nonprofit organization formed by a

number of African American organizations around the country that

are also very interested in the issue of teen pregnancy prevention

and family preservation. And much has been said that I do agree

with, coming onto the Hill, Isabel Sawhill, one of my colleagues. I

agree that teen pregnancy prevention is extremely critical.

I will tell you, if you are looking for my testimony it is not there.

It is not there because I have been in the field for the last 2 weeks

talking about this issue in the communities, in rural area, urban

areas, and actually forgot that I was supposed to be here today. So

it was fortunate I got home at 1 a.m. and looked at my other calendar and saw this. But again, it was a good thing to do because

it does lead up to what we are talking about today.

I think I heard earlier from Dr. Zill about the importance of

adults being involved in this conversation. We are talking about,

how do we actually prevent teen pregnancies? One of my focused

areas is the adults. I don’t do a lot of discussion and training with

the young people because, for many reasons, I feel this is more of

an adult problem than a teenager’s problem.

I have been invited by communities that do have title V money

to come in and do what we call community training, and I do title

training—is there hope for them, because the focus in most of the

communities is on the African-American community; and we have

seen the data, and I have been very encouraged by the response

that we have gotten because what I try to help the community do

is to take a journey with me, to do something really different, not

just focus on what the kids are doing, but what we as adults have

and have not done? Why is it that at a time in the history of African Americans in this country, where we can have more economic

and educational opportunities than we have ever had, that the data

for our youth looks worse than it has ever looked since we have

been in America?

And we talk about that, how did we get from point A to point

B? How is it that at the onset of 1960 nearly 80 percent of all black

households were headed by two parents. And now we have heard

the data today; it is horrendous.

So what I found in the community is that we don’t have to talk

about political issues. We don’t have to talk about abstinence

versus contraception. We talk about what we can do as a people.

What happened to us? Did we abandon the values that kept us together as a people through slavery and segregation, Jim Crow-ism

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and hangings, and we look at those values, and it is very clear,

once we assess what we did, what changed after integration that

is very clear, that we don’t teach our kids the same things anymore. We don’t talk about delaying sex, waiting until marriage. We

don’t have a strong value on marriage any longer.

I talked to them about the data that is out there, about the

health data study that came out, that was funded by the National

Institutes for Child Health and Human Development, that looks at

what keeps our kids safe, and when they looked in the area of

pregnancy and sexuality, there were four strong points that they

talk about in this report.

The first is the connectedness with parents, how many of us are

connecting with our parents. The second is when a parent gives a

child a very clear, clear message that they do not want that child

to be sexually active, not a kind of nondirective kind of wishywashy response. The third that I think surprised a lot of us is

when the parents give a clear message that they do want their children to use contraception, and what also was surprising in this

study was that 10 percent of the men, young men, I think, between

the ages of either 14 or 15 and 19 in this study, over 12,000 of

them and 15 percent of the young women had taken pledges of

chastity, and that was a surprise to many people.

But what we are trying to do is to paint a vision for our people

about what it can be like for us in the future, what our families

could look like and how do we get there; and it is clear that we

can’t get there by not being very clear what we want our kids to

do and how to do that.

I was a single mom myself for 20 years. I have lived in a devastated inner city community and helping revitalize that community so the teen pregnancies rates would decline, and drug abuse.

And people started their own businesses and bought homes that

they thought they would never have, got off welfare and stayed off

welfare, and it is more than a discussion about whether we should

teach abstinence or use contraception.

And when we can paint the vision, what I have found in every

community I have been in, whether poor rural or urban, the conclusion from the parents is always that we have to teach our children

something better, we have to teach them about delaying sexual

self-gratification, and we have to help them understand why sexual

activity is not in their best sexual interest, best health interests for

the present or the future.

There is a lot more I can say, too, but I do see the red bulb, and

I will stop.

Chairman JOHNSON of Connecticut. Thank you very much, and

thank you for being here. Certainly, your experience in the field is

extremely important to us because you can talk all you want about

the stuff in Washington, frankly, and if you never get out there to

the real world and if nobody ever hears you, it isn’t going to make

a bit of difference.

Mr. Richards.

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STATEMENT OF CORY L. RICHARDS, VICE PRESIDENT FOR

PUBLIC POLICY, ALAN GUTTMACHER INSTITUTE

Mr. RICHARDS. Thank you. We have been hearing this morning

that nonmarital childbearing is an exceedingly complex problem,

and it is, but certainly one of the driving forces behind nonmarital

childbearing in the United States is unintended pregnancy. Among

all the births to never-married women in the United States, 6 in

10 are the result of pregnancies that were not intended. Among

teenage births, and teenagers are overwhelmingly not married,

two-thirds of the births are the result of unintended pregnancies.

So clearly, as we look at a range in societal responses to the

problems of nonmarital childbearing, we need to pay attention to

unintended pregnancy.

The second point I would like to make is that unintended pregnancy is not an intractable problem. We have heard this morning,

and I absolutely agree, that the rates in the United States are

high. They are very high compared to other developed countries;

they are far too high. But the fact of the matter is that rates of

unintended pregnancy in the United States have been coming

down. They have been coming down for all women, including adult

women, and especially for teenage women.

I think we have heard twice this morning that teenagers are not

responsible for the bulk of nonmarital childbirths in the United

States, and I want to say it for the third time. Teenagers only account for about a third of the nonmarital childbearing in the

United States, but for reasons given by Isabel Sawhill and others,

there is plenty of justification for dealing with the problems of our

young, most vulnerable citizens, so addressing teenage pregnancy

is a tremendously important problem.

Having said that teenage pregnancy rates are coming down in

the United States, that naturally raises the question that all you

policymakers want the easy answer to, which is why; and of course,

I can’t give you the easy answer because there is much that we

don’t know about why people are behaving the way they are. But

there are new data from the National Surveys of Family Growth

in 1988 and 1995 that shed some light on what is sort of the firstcut question, which is, how much of this is due to increased abstinence among teenagers and how much is due to other factors?

What we have seen from the NSFG surveys is that between 1988

and 1995 there was a 10 point decline in the teenage pregnancy

rate from 111 to 101 per 1,000 teenagers. During that same period

there was a 2 percent decline in the proportion of teenagers who

reported that they ever had intercourse. But while statistically that

is very small, the fact of the matter is that that 2 percent decline

in sexual activity is responsible for about 20 percent of the total decline that we have seen in teenage pregnancy.

What that means, however, is that 80 percent of the decline has

to do with changes in behavior among teenagers who are sexually

experienced, who have had intercourse in the past; and we looked

at the three possibilities that could be responsible for that. It could

be one or a combination, of either sexually experienced teenagers

having sex less frequently, using contraceptives more in total, or

using contraceptives more effectively. What the data seem to show

is that sexually experienced teenagers are not substantially less

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1Source: Henshaw S, Unintended pregnancy in the United States, Family Planning Perspectives, 1998, 30(1):24–29.

sexually active than in the past. Meanwhile, their total contraceptive use has gone up only very slightly, from about 78 percent to

80 percent. But the real change, and the significant change that is

responsible for the very steep declines that we have seen in pregnancy rates among sexually active teenagers, is a change in method use primarily toward the new long-lasting hormonal methods,

Depo-Provera and the contraceptive implant Norplant, which only

came on the market in the United States in the early 1990s.

By 1995, the second NFSG survey, 1 in 10 teenagers at risk of

unintended pregnancy was using these methods, and we think that

that is the critical reason that pregnancy rates among sexually active teenagers went down.

Earlier, Stephanie Ventura talked about the very steep decline

we have seen in second pregnancies to teen moms, and it would appear that the use of these long-lasting contraceptives is even more

important among these teenagers because about one in four of

these teenagers is using these methods.

So, to sum up, it seems to me that in the great controversy over

whether this is due to abstinence or contraception, it is not an either/or situation, that both seem to be at play here, though not in

the same proportion; and I would suggest that the policy implications of that are relatively clear, or they seem relatively clear to

me, which is that even as we continue to promote abstinence with

our young people, we need to recognize that half of the teenagers

in the United States still are sexually active and that access to the

information and the contraceptive services that they need to protect themselves need to be preserved as well.

Chairman JOHNSON of Connecticut. Thank you. That was very

interesting, and it does remind us that this is a complicated problem and certainly contraception plays a role.

[The prepared statement follows:]

Statement of Cory L. Richards, Vice President for Public Policy, Alan

Guttmacher Institute

Good morning. My name is Cory Richards, and I am Vice President for Public Policy at The Alan Guttmacher Institute (AGI), an independent, not-for-profit corporation for reproductive health research, policy analysis and public education. In compliance with clause 2(g)(4) of House Rule XI, I have submitted to the subcommittee

information on relevant federal government grants received by AGI.

Thank you, Madam Chairwoman, for inviting me to speak to you and members

of the subcommittee this morning as you consider a range of questions related to

the goal of reducing nonmarital births.

Nonmarital childbearing in the United States is an exceedingly complex matter;

it represents the coming together of a variety of factors. But no matter how you cut

it, one central force driving nonmarital birth is unintended pregnancy. Fully six in

10 births to never-married women are the result of pregnancies that were unintended. Among teenagers, most of whom are unmarried, fully two-thirds of all births

are the result of pregnancies that were unintended.1 As a result, although there are

many ways in which we, as a society, can work to alleviate problems associated with

nonmarital births, it is clear that confronting the issue of unintended pregnancy is

absolutely critical.

In that light, it is heartening to be able to report that there is some very good

news on the unintended pregnancy front: Unintended pregnancy rates in the United

States began to decline over a decade ago, and that decline has continued into the

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2Source: Ibid.

3Teen birthrates dropped 12%, from 62.1 to 54.4 per 1,000, between 1991 and 1996. In 1986,

the birthrate was 50.2. Source: The Alan Guttmacher Institute (AGI), Teenage pregnancy, overall trends and state-by-state information, New York: AGI, 1999. 4The teen abortion rate was 42.3 in 1986; in 1996, it was 29.2. Source: Ibid.

5 Nonmarital births to teenagers account for 31% of all nonmarital births. Source: Ventura,

SJ et al., Births: Final data for 1997, National Vital Statistics Report, 1999, Vol. 47, No. 18,

Tables 2 and 17. 6See Maynard RA, ed., Kids Having Kids: A Robin Hood Foundation Special Report on the

Costs of Adolescent Childbearing, New York: The Robin Hood Foundation, 1996. 7The 1988 and 1995 National Surveys of Family Growth.

8 In 1990, the pregnancy rate among sexually experienced teens was 224; in 1996, it was 190.

Source: Saul R, Teen pregnancy: Progress meets politics, The Guttmacher Report on Public Policy, 1999, 2(3): 6–9. 9 A somewhat lower proportion of sexually experienced young women reported having had

intercourse in the three months prior to the National Survey of Family Growth in 1995 than

in 1988 (79% vs. 81%); however, over the entire prior year, sexually experienced young women

reported having had intercourse during the same average number of months in both the 1988

and the 1995 NSFG (8.6 months). Source: Ibid. 10 A greater proportion of sexually experienced teens reported currently using a contraceptive—using one within the last month—in 1995 than in 1988; that number grew from 78% to

80%. Source: Ibid. 11Source: Ibid. 12Source: Ventura SJ, Mathews TJ and Curtin SC, Declines in teenage birth rates, 1991–

1997: National and state patterns, National Vital Statistics Reports; 1998, Vol. 47, No. 12.

1990s. Indeed, the unintended pregnancy rate among all women of reproductive age

dropped fully 16% between 1987 and 1994.2

On the teenage pregnancy front, the news is especially good: After years of steady

increases, U.S. teen pregnancy rates have dropped markedly this decade. Teen pregnancy rates peaked in 1990, and then fell 17% between 1990 and 1996. Likewise,

teen birthrates have fallen off since 1990,3 and teen abortion rates fell by almost

a third between 1986 and 1996.4 While, contrary to popular belief, teens do not account for the majority of nonmarital births,5 childbearing among unmarried young

women is quite properly of particular concern to us all, since young mothers and

their children are especially vulnerable to severe adverse social and economic consequences.6

Why have teen pregnancy rates fallen? Answers to this question are crucial, as

they can—and should—inform how we can sustain these positive trends among

teenagers, as well as shed much-needed light on ways to address the phenomenon

of unintended pregnancy that is shared by women of all ages.

Careful analyses of key government data 7 indicate that approximately 80% of the

declines that we have seen in teen pregnancy can be attributed to declines in pregnancy rates among sexually experienced teenagers. Indeed, the drop in pregnancy

rates among sexually experienced teens has been very marked—16% between 1990

and 1996.8

Declining pregnancy rates among sexually experienced teens must be attributable

to one or more of the following three factors:

• less frequent sexual activity;

• an overall increase in contraceptive use (that is, an increase in the proportion

of sexually experienced teens using a contraceptive);

• and/or improved—in other words, more effective—contraceptive use.

Government data do not bear out a decrease in levels of sexual activity among

sexually experienced teens.9 On the other hand, there is evidence that a slightly

larger proportion of sexually active teens are using contraceptives,10 and—even

more significantly—that teens who do use contraceptives are using more effective

methods. Most notably, there has been a substantial shift among sexually active

teens toward use of highly effective, long-acting contraceptive methods—the contraceptive injectable, Depo-Provera and the contraceptive implant, Norplant. These

methods only hit the U.S. market in the early 1990s, but by 1995, one in ten sexually active teen women at risk of unintended pregnancy was using one of them.11

Because these long-acting methods are so effective and so easy to use, they are making a big dent in the teen pregnancy rate.

Use of Depo-Provera and Norplant may have played a particularly large role in

reducing second pregnancies among teen mothers. Data released earlier this year

by NCHS showed a dramatic 21% decline between 1991 and 1996 in the proportion

of teens giving birth a second time.12 During a corresponding time period, as NCHS

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13 Using data from the 1995 National Survey of Family Growth, NCHS researchers estimate

that about one-fourth of teens who are mothers are using Depo-Provera or Norplant. Source:

NCHS, Unpublished tabulation, 1999. 14The percentage of 15–19 year old women who say they have ever had sexual intercourse

was 52.6% in 1988 and 51.5% in 1995. Source: Saul R, 1999, op. cit. (see reference 8). 15Seventy-eight percent of pregnancies among 15–19-year-old women are unintended. Source:

Henshaw S, 1998, op. cit. (see reference 1). 16 An estimated 16.5 million women in the United States are in need of publicly subsidized

contraceptive services. That is, they are sexually active, fecund, not pregnant and not trying to

become pregnant, and are either teenagers or have a family income below 250% of the federal

poverty level. Only 27% of women in need of such services are married. Of those who need publicly funded services, it is estimated that four in 10 women were served by a public family planning clinic in 1995. Source: AGI, Contraceptive Needs and Services, 1995, New York: AGI, 1997.

researchers have pointed out, a relatively high proportion of teen mothers—one in

four—were using long-acting methods.13

Our analyses additionally confirm that there has been a decline—or at least a leveling off—in the proportion of teenagers who have ever had sexual intercourse. Indeed, the proportion of women aged 15–19 who report they have ever had sexual

intercourse decreased about one percentage point between 1988 and 1995.14 About

20% of the declines in the overall U.S. teen pregnancy rate is attributable to this

increased abstinence.

Many questions remain around why teen contraceptive use has improved, and

why more teens are remaining abstinent, but the bottom line is that both phenomena are making a difference in combating teen pregnancy. As we have seen,

about 20% of that difference is attributable to increased abstinence; about 80% is

due to more successful pregnancy prevention efforts among teens who are sexually

active. This strongly suggests that even as abstinence is being promoted to our nation’s young people, access to contraceptives for those teens who are sexually active—half of all U.S. teens—is also vitally important to reducing teen pregnancies,

fully eight in 10 of which are unintended.15

In fact, access to highly effective contraceptives can—and clearly does—make a

difference in reducing unintended pregnancy and, as a result, nonmarital births

among all women. Since low-income women are especially vulnerable to unintended

pregnancy and nonmarital childbearing, government-subsidized family planning

services are key to addressing these issues. I applaud the efforts of committee members who worked to ensure that TANF funds can be used for family planning services. The unmet need is great,16 and new funding under TANF is a small but important step in the right direction.

though, about his interest in abstinence programs. I, too, am very

Thank you.

Chairman JOHNSON of Connecticut. I did want to ask Mr. Rector,

f

interested in abstinence programs, and as impressed as I am with

the Best Friends program—and I haven’t been out there to visit,

I just read about them—I have to tell you that there is a program

that my hometown has had over either 6 or 8 years—I can’t remember how long the program has been in place, and unfortunately, its structure was not able to come today, but they have had

one pregnancy over all the area through the years, and that pregnancy was by a male who had dropped out of the program 2 years

earlier.

But their commitment to these kids is, once you are in, you are

always in, and you are always our person and we count you in our

statistics, which I think is a very high standard. And it is very interesting to me because they absolutely stress abstinence, but they

also teach sexual health, I mean personal health, and they also

teach about contraceptives; and they don’t have a problem with

this mixed message stuff, but I think it is because they do it regularly over time. It is a very normal part of the conversation.

84

The kids hear things on the street, they can bring it back. They

hear things in school, they can ask about it. And they don’t qualify

for $1 of Federal money because they aren’t sufficiently pure, but

their record is better than any abstinence program I am aware of.

So as much as I agree with you that abstinence has to be talked

about more and certainly, Ms. Ware, that is what you are fighting

is that we need to know how to talk to young people. How do some

of us grow up with that assumption? I mean, I can’t remember my

parents ever talking to me about it, but I certainly know what they

thought about these things, and they did influence not only my behavior, but every kid I knew. Of course, that was helpful since

there was more uniformity.

But would you support abstinence programs, abstinence funding

going to programs on the basis of their performance and a little

less on the basis of whether or not they teach about contraceptives

or don’t teach about contraceptives?

Mr. RECTOR. I think there are a couple of points. First of all,

when people are looking at the pure abstinence programs directed

towards marriage, sometimes there is a suggestion that we are trying to deny children information. In almost all the schools where

these programs, for example, the Best Friends program, there is information about birth control provided in some context in the

school. It it not like we are going and pulling books off the shelves

and ripping pages out and things like that.

What I feel is the most—what we see in these programs is that

the program providers have to believe in the message, and what we

were concerned about in drafting title V was that if you allowed a

simple mixed message, what we would get was the same old sex

ed program, but, where somebody puts the word ‘‘abstinence’’ on

the front cover—actually—even with the tight definitions in title V,

we got more of that bogus abstinence than we got real abstinence,

I think. It is very important that the presenter and the teacher

really believe it, because you are asking them to—.

Chairman JOHNSON of Connecticut. I appreciate that very much,

and I think when you first start something like this, you have to

be perhaps a little more focused than you do later on.

But what would be wrong now with a program that has been established and that can demonstrate highly effective abstinence performance, why would we need then to be quite so judgmental in exactly how they do it? Clearly, they are committed to the message

of abstinence, there is no question about it; but by having them

both in the same place, as opposed to someplace else in the school,

the trust issue is very, very great—what can we ask, and whom

can we trust to talk to us straight—and I would hope that you

would think about whether or not you and your organization would

be willing to support a certain portion of this money going on outcomes like that.

Mr. RECTOR. I think, first of all, still—even within title V, I think

that the predominant number of programs, despite the rigor of the

definitions in those programs—and I am glad you have got a program that is firmly committed to abstinence and is communicating

that message. I think that the majority of title V programs really

aren’t committed to that; that would be my experience. There are

some very good ones out there. There might be some good mixed

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message programs, but by and large, even within title V, I think

the abstinence component is quite weak, and therefore, I think that

that kind of change would be premature.

I think the program that you are talking about could be very well

funded under other programs, but basically, I would like to see

most of the title V programs get up to speed.

Chairman JOHNSON of Connecticut. See, first of all, I would have

to say this: These kids live in a mixed message world, and having

a program that is not capable of talking about both is a weakness.

But I certainly would hope that you would give some thought to

working with us on outcomes. I mean, the abstinence program has

been in place long enough now. Why can’t we have a portion of that

money go to outcomes? Have you performed? Are your kids abstaining?

So I think once a program’s been in place a little longer, then you

are obliged to look at the outcome, and if you are abstinence and

you are talking abstinence and your rate of pregnancy is high, you

shouldn’t get the money; I don’t care what you are talking about,

you know.

So we will be looking at changing that language, but I wanted

you to understand that it was because I personally believe that

there are high-performing abstinence programs out there, and that

I have an obligation to make sure that the money goes to help kids

not get pregnant.

Mr. RECTOR. That would be fine.

I would also recommend, though, that in looking at evaluations,

we ought to evaluate title X and a lot of these other programs

which have been around much longer than title V, have not been

evaluated and are not rewarded by outcome. One of the things we

were trying to do with title V was to create some diversity, because

there really wasn’t a lot of strong abstinence, certainly not federally funded strong abstinence out there, and my feeling is that if

you weaken the definition of that, far from creating, we would just

fall back into——

Chairman JOHNSON of Connecticut. Oh no, I don’t think we are

talking about weakening definitions. I think we are talking about

strengthening focus by looking at outcomes, not weakening definitions. So I think we just have to recognize the complexity of the

problem and that programs that develop the kind of trust you need

amongst kids cannot be forbidden from talking about the realities

of those children’s surroundings.

Mr. RECTOR. Again, I could—you know, I think we are both

aware that one of the strong potential problems here is what we

would end up with is a condom promotion program that has abstinence tacked on the front end. And I think everyone agrees here

that the value base that is in the program that you are talking

about and the ones I am talking about is a critical feature, and we

wouldn’t want to jeopardize that.

Chairman JOHNSON of Connecticut. We certainly don’t, but we do

want to make sure that the programs that are working have some

support to expand.

Dr. Nathan—Mr. Nathan.

Mr. NATHAN. I would like to make a comment about that. In my

testimony on page 9, the bottom of the page, I point out that TANF

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and MOE funds—and there have been quite a few recent reports

that say this—can be used for other kinds of programs, like the

programs you are speaking about. I think that it maybe isn’t the

law that needs to be changed, but there needs to be a greater understanding of this.

A lot of people, I think, out in the country don’t realize that, and

so that might be a way to educate without having to legislate.

Chairman JOHNSON of Connecticut. Thank you. I do want to go

back to the issue in your testimony about connectivity and just

briefly ask you to comment on the apparent difficulty we are having in Medicaid sign-ups and whether that represents sort of a bureaucratic connectivity problem and whether there are ways that

we could better focus the welfare reform bureaucracy, as it is evolving, to better connect with public health agencies and, you know,

the kinds of programs that could reach teens and women on this

issue of unmarried births.

Mr. NATHAN. I appreciate the chance to comment on that.

It is not surprising that in delinking AFDC and food stamps and

Medicaid that we are seeing the kinds of effects that are occurring.

In my opinion, the key is that welfare reform is a work in progress.

The key to what happens is information technology and building

systems that workers at the front line can use to make connections

and track services—both services and safety net programs. Right in

this room last week, on Friday, we held the fifth meeting of the

Rockefeller Institute-General Accounting Office ‘‘Working Seminar

on Information Systems for Social Programs.’’

I am not a techie, I don’t do this stuff myself, but I think this

is the future in terms of what the new welfare becomes. TANF is

bigger than welfare. The challenge now is to build systems. The

young people who are being hired and work in these bureaucracies

aren’t afraid of the technology. It is off the shelf technology. The

money is out there; there is a good spirit about welfare reform now.

It is not as controversial.

This is the moment, with the economy performing the way it is,

to put a lot of emphasis on making connections with information

systems that workers can use on the front lines for health services,

just as you said, and for safety net programs and for job programs.

We had people from different States come and talk about what

is going on in the country. Like Diogenes with the lantern, I have

been out there looking for the best way to do this. There are efforts

going forward. I think this is the most important finding of our research, namely about building management systems with information technology where I think the Federal Government can help. I

have been going around in Washington trying to urge Federal

agencies and people around in different key areas in Washington

to support this. The staff of this Subcommittee has been very active

and helpful in this. In fact, Comptroller General David Walker,

who attended on Friday, specifically thanked you for letting us use

this room for our meetings.

Chairman JOHNSON of Connecticut. I see from your larger report

on the 20 sites and I see in my own experience that the better connection between the welfare eligibility bureaucracy and the job

training job placement bureaucracy is having a very powerful effect. I don’t see developing yet any healthy connection between that

87

bureaucracy and the substance abuse prevention people, substance

abuse treatment people, the mental health resources are completely lacking. As we get more into this, that is going to be very,

very important, and then on this issue of the means, the reasons

for not having children out-of-wedlock, not having that second

birth, we are not connecting well into the sort of information about

that, why you wouldn’t do that, what it means for your future,

what it means for the child’s future and what are your options.

Mr. NATHAN. That is exactly right, and it is a big opportunity,

and wherever it is happening we should understand that and use

information about best practices to promote these kinds of changes.

It is really the future of the new welfare right there.

Chairman JOHNSON of Connecticut. Yes, Ms. Ware.

Ms. WARE. Mrs. Johnson, I just wanted to make one quick comment on your concern about perhaps opening the title V money to

organizations that also discuss contraception. I did a manual on abstinence, an abstinence resource manual, looking at all of the abstinence programs and what worked in these programs, whether they

had been evaluated and so forth. Many of the very good programs

do talk about contraception. I think it is a misrepresentation that

abstinence programs—abstinence only programs don’t mention contraception or condoms. They do. Many of them do. But it is the way

they are talked about, it is in what context, and it in no way suggests to the young person that sexual activity is an OK behavior

if you think you are mature enough or if you think it is your choice,

that kind of thing. It lets young people know that if this is what

you will do, and some kids are going to regardless of what you say,

that there still is a risk factor involved for you, and we spend most

of the time trying to help them understand why waiting is better

and then helping them develop the skills to do that, give them

something to look forward to in the future, those kinds of things.

But there is a—the most serious difference between programs

that also provide contraception and consider themselves abstinence-based and abstinence only is not that one talks about contraception and the other doesn’t. It is that under no circumstances

will the abstinence-only program encourage sexual activity in any

way. It is a fine point——

Chairman JOHNSON of Connecticut. It would be very hard to see,

you know, how they would oversee that. I mean certainly there is

no question in my mind, but there is this program at home in my

district that certainly has that message but they have not received

any abstinence money. Now, I don’t know whether it is the general

suspicion that new England isn’t sufficiently morally straight, but

I think that one way of dealing with this problem, because it is

very hard from the outside to judge that, is to begin to look at outcomes data when we have it.

Ms. WARE. Right.

Chairman JOHNSON of Connecticut. We do in every other area,

and it just blows my mind that we could ignore a program that has

had one pregnancy over 6 or 8 years from a kid who dropped out.

So I think that—I think we do have to look at a variety of tools,

and I think you can do that without diluting it, and I think your

comment about the fact that many of these abstinence programs do

88

also provide information that kids really need to know or at least

some kids need to know is interesting.

Bell, did you want to comment?

Ms. SAWHILL. Can I jump in, is this Pathways/Senderos, and by

the way it is a wonderful program, and we have written it up in

one of our national campaigns to prevent teen pregnancy because

one of the things that is needed when there are good programs like

this is other people around the country need to know about them

and be able to use them as models of best practice.

Chairman JOHNSON of Connecticut. Just for a moment on that

issue, they are now seeing kids not able to come regularly to their

program because they have to stay home this summer and take

care of the children, their brothers and sisters, and the neighborhood wants them to start a program for younger children so they

could have a summer program that would be totally abstinence because these are under fifth grade. The fifth grade teachers talked

them into starting a fifth grade class, and they have only had the

kids for 3 months and their grades have gone up and their behavior has improved. This is a very, very successful program, but it

doesn’t—so there is something wrong when you can’t look at results.

Ms. SAWHILL. I love your idea of a more outcome-based focus for

the use of these funds, and I think it is exactly the right way to

go. I think one of the problems with teenage pregnancy prevention

programs is they have not been adequately evaluated in the past.

We know far too little about how to achieve success in this area,

and as a result of that, we are, you know, sort of flying blind.

Now, I am very pleased that you all did put some funding for

evaluating at least the abstinence-based programs into the welfare

reform amendments and that some of that is going on now, and we

all look forward to seeing the results, but I think we need still

more evaluation, and our advisory panel, which I want to thank

you for being a part of, by the way, to the national campaign, has

been looking at this issue, and the co-chairs of that panel, as I

think you know, Mr. Castle and Ms. Lowey, have co-sponsored a

bill that would call for more outcome-based programs and more

money for evaluation and then funding of the ones that have been

demonstrated to be effective through those evaluations and spoken

to some people on the Senate side as well who are also interested

in that. So I just wanted to sort of flag that as being very consistent with I think what your ideas are here.

I think what you say about what people on the ground are going

to do, what they think is best, is absolutely right as well. I think

it is very good that the Congress has changed the debate, and I

give my friend Robert and others in the conservative community

lots of credit for having changed the discussion about these issues,

but I think in the end when you are talking about actual teachers

and mentors and others in local communities working with kids,

they have to be given the flexibility to work with those kids in

whatever way they think is effective.

I would point you to the example of South Carolina where the

legislature did allocate some funding for teen pregnancy prevention

last year, and they are putting the money out to all of their local

communities with complete flexibility in terms of how the money

89

is used, and it seems to me that, you know, that is the model we

have to build on. We have to change the conversation about this,

but in the end, we have to give the people who are actually running the programs a fair amount of flexibility.

Chairman JOHNSON of Connecticut. I do think it is very important, and certainly my goal is not to substitute the legislation that

has been introduced as interesting, as I think it is, for the language

in there. I think it is just that you want to create also a way in

which programs can be viewed by the accomplishments they have

achieved, but I do just want to mention one other fact.

When you look behind any of these programs, and they are providing role models. They are helping kids with their homework.

They are giving kids some view of other career options. You know,

they are not succeeding on the issue of abstinence on simply moral

authority ground. They are connecting not having children with

having power over your life and opportunity, and that is I think

why the message succeeds.

So as important as the issue of abstinence and/or contraceptives

is, the real power of these programs is that they help kids do better

in school. They give them an alternative to unstable homes often,

often though not always, and they give them a way to see what

else they could do in life besides go on welfare.

Mr. RECTOR. If I could just reinforce the one point that Dr. Nathan made that I thought was very important vis-a`

-vis your program, all the TANF surplus funding in the State could be used for

that program.

Chairman JOHNSON of Connecticut. I appreciate that. For me it

is a matter of principle, Mr. Rector. I think since they are focused

on this they are serious about abstinence, and they are performing,

and they are having great results. So I think for, ‘‘abstinence funding to cut them out is simply wrong,’’ see. So, yes, there are other

sources. I mean, they have been up and running and they have gotten national attention, but I don’t think it is right, and I appreciate

your point that you don’t want to—you fear dilution and you——

Mr. RECTOR. Dilution is already here.

Chairman JOHNSON of Connecticut [continuing]. Fear under the

original law that you would have just simply rubber stamped old

programs with a new name, but I don’t think that relieves me of

the responsibility to really look at programs that focus on abstinence, that achieve abstinence but may not, for microtechnical reasons—see, it is very judgmental when you get down to this level

of are they talking about contraceptives or are they not and what

is their intention in talking with them. So this is really bad territory. The Government really can’t evaluate that. So I have to look

more closely at that law, and we certainly would keep you informed. I just wanted to alert you to the fact that I do think outcomes matter a lot, and some of the programs that are working

really hard at abstinence in the very heart of poor urban areas and

succeeding, they deserve recognition.

Mr. RECTOR. I think it is important to realize that title V represents only a very, very small fraction of the amount of money

that the Government is spending on sex ed and only a small fraction of title V is going to abstinence-only programs. We were trying

to break the mold and to move, particularly public health instituVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00093 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
90

tions, in a new direction. If we are going to go with—outcome-based

funding and things like that, I think it is very important to look

at all the sex ed funding that is coming out of HHS and not just

title V.

Title V is a brand new program. We now have better evaluations

on title V than we do on all the bulk of the other programs that

have been around for decades. I would commend to you a very important thing that we could do is call for the same sorts of evaluations on title X and other sex ed programs or abstinence-plus programs. In the long run, we want the same thing that you do. I am

just afraid of the bureaucratic inertia. If we didn’t clearly say we

want you to do something different—the bureaucracies in the State

level are very, very hostile to abstinence-only. So if we drop the

strict definition, I think most abstinence-only programs would vanish. We wouldn’t even get to experiment, we wouldn’t get to evaluate abstinence only because the programs wouldn’t exist, and that

was our concern.

Chairman JOHNSON of Connecticut. Yes, Mr. Richards, then we

must go on to the next panel.

Mr. RICHARDS. I would just like to make the point that title X

is not a sex education program. It is a family planning services program. Two-thirds of the clientele in family planning clinics are

adults, in addition to which there have been many evaluations of

the program over the years in terms of its impact on preventing

pregnancies.

Chairman JOHNSON of Connecticut. I would just say that in my

district, which is really, I mean my biggest city is 65, 70,000, it is

going down so I never quite know, title X and some of the poor cities in my district where they have no community health centers,

they were the only access women had for pap smears, but family

planning is very important to married couples. Married couples

need to be able to have the number of children they want to have,

and they should not be in a position of having to decide about

whether to have an abortion or not.

I mean, my husband in the early days when abortions were illegal stood at the bedside of a mother of five with a husband standing there, and she died of an aseptic abortion, and she died because

they could not tolerate the economic burden of one more child, and

they had not been able to prevent the pregnancy. So that was a

part of life at that time, and as much as I think we need to retrain

our children and ourselves as adults and do something about the

mixed messages out there and this terrible problem of children

being born in circumstances that do terribly prejudice that child to

destitution and failure, I also think the lack of healthcare for uninsured women, the terrible importance in a free society of being able

to control whether you have more children or not is something that

unfortunately title X has been a weak small lever, but it has been

all we have been able to do, and I think the issue of teen pregnancy

is really a different issue and we need to think about it and act

on it far more aggressively than we have. I think it is the one area

in which there is consensus, and we do need to work more effectively, and we have some better information now from the abstinence program.

91

THE ALAN GUTTMACHER INSTITUTE

Washington, DC, July 20, 1999

The Honorable Nancy L. Johnson,

Chairman, Committee on Ways and Means

U.S. House of Representatives,

Washington, DC.

Dear Madam Chairman:

This is in response to your request for additional information concerning the calculations that led to our conclusion—presented by Cory L. Richards, The Alan

Guttmacher Institute’s (AGI) vice president for public policy, in his testimony before

the Subcommittee on June 29—that, to varying degrees, both increased abstinence

from sexual activity among teenagers and changes in contraceptive behavior among

sexually experienced teenagers contributed to the observed decline in the pregnancy

rate among U.S. teenagers between the late 1980s and the mid–1990s.

These calculations, which are detailed below, were based on the following data

sets:

• Pregnancy rates—released by AGI in April, 1999 in ‘‘Teenage Pregnancy: Overall Trends and State-by-State Information’’—are based on birth rates from the National Center for Health Statistics and abortion data from periodic AGI Abortion

Provider Surveys. Information on the proportions of young women who have had

sexual intercourse are from the National Center for Health Statistics’ 1988 and

1995 National Surveys of Family Growth (NSFG).

• Information on sexual activity and contraceptive use is from the 1988 and 1995

NSFG.

• Overall contraceptive failure rates are based on NSFG information on contraceptive use and from first-year failure rates calculated from the 1995 NSFG and the

1994–95 AGI Abortion Patient Survey http://www.agi-usa.org/pubs/journals/

3105699.html).

In 1988, the pregnancy rate was 111.4 per 1,000 women aged 15–19, and 52.6%

of women aged 15–19 had had sexual intercourse, for a pregnancy rate per 1,000

women aged 15–19 who ever had sex of 211.8 (.526 * 211.8 = 111.4). In 1995, the

pregnancy rate was 101.1 per 1,000, and 51.5% of women aged 15–19 had had sex,

for a pregnancy rate per 1,000 women aged 15–19 who ever had sex of 196.3 (.515

* 196.3 = 101.1).

Between 1988 and 1995, the pregnancy rate per 1,000 women 15–19 declined by

10.3 pregnancies per 1,000 women, from 111.4 to 101.1. The relative contributions

to this decline from the change in the proportion of women aged 15–19 who ever

had sex and from the change in the pregnancy rate among those who ever had sex

can be determined by calculating what the pregnancy rate in 1995 would have been

if only one of these factors changed.

If only the proportion of women who ever had sex had decreased (from 52.6% in

1988 to 51.5% in 1995), given the pregnancy rate of 211.8 per 1,000 sexually experienced women aged 15–19, the overall pregnancy rate per 1,000 women aged 15–19

in 1995 would have been 109.1 (.515 * 211.8 = 109.1). The pregnancy rate would

then have fallen by only 2.3 pregnancies per 1,000 (from 111.4 to 109.1). Thus,

roughly 20% of the actual decrease of 10.3 pregnancies per 1,000 (2.3/10.3 = 22%)

was due to the lowered proportion sexually experienced.

Similarly, if the proportion of women aged 15–19 who ever had sex had stayed

stable at the 1988 level of 52.6%, and only the pregnancy rate among sexually experienced women aged 15–19 had fallen (from 211.8 in 1988 to 196.3 in 1995), the

overall pregnancy rate in 1995 would have been 103.3 (.526 * 196.3 = 103.3). This

decrease of 8.1 pregnancies per 1,000 due to the lowered pregnancy rate among sexually experienced young women is roughly 80% of the observed decline in the pregnancy rate per 1,000 women 15–19 (8.1/10.3 = 79%).

The question, then, is how the decrease in the pregnancy rate among sexually experienced young women occurred. Three factors were investigated—whether these

women reduced the frequency with which they had intercourse, increased their use

of contraceptive methods or became more effective users of contraceptives.

Regarding the first factor, changes occurred between 1988 and 1995 in the sexual

activity of women aged 15–19 who ever had sex, but they offset each other so that

there was no change in the average number of months in the prior year during

which sexually experienced women aged 15–19 had had intercourse (8.6 months in

both years).

Regarding the second factor, contraceptive use at first intercourse increased substantially between 1988 and 1995, but ongoing use at the time women aged 15–19

92

were surveyed increased only slightly, from 78% to 80% of women aged 15–19 who

were having sex, fertile and not pregnant, postpartum or trying to become pregnant.

Regarding the third factor, there were important shifts in the types of methods

used. Condom use increased slightly, and reliance on oral contraceptives declined

substantially. At the same time, however, long-acting methods, such as the

injectable and implant which were not available in 1988, accounted for 14% of current method use in 1995. Because of this shift to long-acting methods, the estimated

overall first-year method failure rate for teen contraceptive users dropped 9%, from

16% to 15%.

The observed decline in the pregnancy rate among sexually experienced teens appears to be attributable to these two changes in contraceptive use, the modest increase in the proportion of users and the substantial decline in their overall failure

rate.

We hope this information will be helpful to you. It will be expanded upon and

placed in a larger context in a monograph to be published this fall, and we will be

certain to sent you a copy at that time.

Sincerely,

JACQUELINE E. DARROCH, PH.D.

Senior Vice President and

f Vice President for Research

I am sorry to take so long. We really must be on to the next

panel, but thank you very much for your participation and your

help, and I look forward to working with you.

Brenda Miller, who is deputy director of the National Campaign

to Prevent Teen Pregnancy of the Urban Institute; Rebecca Maynard, the project director for the National Evaluation of Title V Abstinence Education Programs, Mathematica Policy Research; Edward Tetelman, the assistant commissioner of the New Jersey Department of Human Services; and John Sciamanna, senior policy

advocate in the American Public Health Services Association.

We welcome you here today. I very much appreciate your participation. I am very pleased to have Rebecca Maynard here and her

evaluation of the title V programs and would ask Ms. Maynard to

start.

STATEMENT OF REBECCA A. MAYNARD, PROJECT DIRECTOR,

NATIONAL EVALUATION OF TITLE V ABSTINENCE EDUCATION PROGRAMS, MATHEMATICA POLICY RESEARCH,

INC., AND UNIVERSITY OF PENNSYLVANIA

Ms. MAYNARD. Thank you, Madam Chair. It is a real pleasure to

be able to talk with you about the ttle V abstinence education programs and the lessons that should be coming from the congressionally authorized evaluation of these programs.

As project director for the National Evaluation of Title V Abstinence Education Programs, I have had the privilege of seeing firsthand a number of quite exceptional programmatic initiatives aimed

at addressing head on the issues of teenage sex and out-of-wedlock

childbearing through abstinence only education programming. Our

mission in the evaluation is to identify effective, replicable abstinence education models, and as many of you know, there is a wide

range of programs being supported through section 510 of title V.

The funded activities out there range from State level media

campaigns to high intensity, multifaceted, multi-year youth development initiatives. A handful of the States have opted for a single

statewide intervention strategy, but most of the States have chosen

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to fund a diverse set of initiatives ranging from brief curriculumbased classroom programs that are offered communitywide to more

extensive targeted classroom programs that are complemented by

strong boosters that reinforce the abstinence messages and that

provide youths with alternatives to high-risk behaviors.

Many States also have supported some communitywide initiatives that are using abstinence-only messages in an effort to alter

youths’ behaviors through systemic changes in community norms

and opportunities and the support structures available.

Now, I can’t speak to the overall implementation of the title V

abstinence education program. However, in the course of our preliminary evaluation work we have observed a wide range of the

programs that are out there funded under this legislation, and I

am going to just illustrate with five programs some of the efforts

that we have observed.

There is a locally-funded—locally-designed program in Florida

that has developed an abstinence only curriculum offered to youth

in grades 6 through 12 as a year-long elective class. The class

meets 5 days a week. Students receive unequivocal messages about

the value of abstinence, the power of building positive relationships

and the strong benefits of marriage. These classroom curricula activities are reinforced and extended to encourage parent support

through regular home visits by trained social workers.

Another program that we have spent time with is a very intensive program operating in New Jersey that follows a leading national abstinence education program model. This is a school-based

program that provides girls with between 100 and 200 hours of

interaction with responsible adult mentors, most of whom are

teachers. This intervention extends over a minimum of 3 years. In

addition, the program includes health and fitness components, and

it offers a structured curriculum covering topics such as friendship,

decisionmaking, love and dating, self-respect and substance abuse.

So it is fairly broad-based.

In several Wisconsin middle schools there is a program that

works with youth for 2 hours every day after school. This program

delivers strong abstinence messages in every one of these after

school sessions through a variety of means, including through a formal curriculum that emphasizes knowledge of anatomy, that provides information about sexually-transmitted diseases and talks a

lot about the values of marriage. It also offers positive skill building activities such as job shadowing and exposure to cultural

events. Youth generally stay in this program throughout the middle school years once they come in, and many of the kids have an

opportunity to enroll in the summer program which lasts 7 weeks.

Kids are in the summer program all day, every day, 5 days a week,

again getting more of the abstinence curriculum, more of the youth

development activities and the strong abstinence messages.

Virginia has a program for eighth and tenth graders that uses

a nationally marketed abstinence education curriculum. The program classes, which meet about 30 times a year, address abstinence in the context of a curriculum that is strongly focused on

character development. The school-based abstinence education efforts are bolstered by media campaigns, an information and referVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00097 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
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1 University Trustee Professor of Education and Social Policy at the University of Pennsylvania and Project Director for the National Evaluation of Section 510, Title V, Programs being

conducted by Mathematica Policy Research, Inc., and the University of Pennsylvania (HHS–

100–98–0010).

ral service and communitywide workshops on various aspects of

parenting, youth development and abstinence.

The final example I will give you is Texas, which has a communitywide initiative that is reaching students in more than two

dozen school districts with a national abstinence education curricula. This program has trained nearly 200 teachers to deliver the

school-based curriculum. It engages physicians and counselors to

staff hotlines where they answer questions about sexually transmitted diseases and other health risks associated with teen and

out-of-wedlock sex. It produces and airs media spots. It has developed and administered tools to train medical professionals in the

promotion of abstinence. It has organized community mentoring

programs for youth, and it has instituted a monitoring and assessment effort to help guide its community efforts.

The evaluation that we are working on is going to capitalize on

the breadth and depth of programming that is being supported

through title V abstinence education to provide much needed evidence regarding the potential of these various programs. Moreover,

the evaluation is going to focus on models that are adaptable to different circumstances, for example, for communities that are willing

to institutionalize programs in schools versus those that are only

going to institutionalize programs in the community setting or in

after school settings.

In the evaluation, we have committed to the most rigorous standards for conducting our studies. We are going to rely on experimental design studies with large samples of youth to document the

impacts of the various programmatic strategies on youths’ behaviors, their knowledge and their attitudes. Then, we are going to

complement the rigorous impact analysis with extensive qualitative

research so that we can document the nature of the interventions,

the circumstances and strategies for their successful replication

and the mechanisms through which the programs can strengthen

family values and responsible decisionmaking.

Thank you.

[The prepared statement follows:]

Statement of Rebecca A. Maynard, Project Director, National Evaluation of

Title V Abstinence Education Programs, Mathematica Policy Research,

Inc. 1 and University of Pennsylavinia

The Personal Responsibility and Work Opportunity Reconciliation Act (P.L. 104–

193) authorized federal expenditures of $50 million annually for five years beginning in fiscal year 1998 to support state efforts promoting abstinence-only education. A congressionally authorized evaluation is now underway, funded through

the Office of the Assistant Secretary for Planning and Evaluation within the U.S.

Department of Health and Human Services.

As Project Director for the National Evaluation of Title V Abstinence Education

programs, I and my colleagues have had the privilege of seeing firsthand a number

of quite exceptional programmatic initiatives aimed at addressing head-on issues of

teenage sex and out-of-wedlock childbearing. Our mission in the evaluation is to

identify effective, replicable abstinence education models that are funded under the

recent welfare reform legislation. Toward this end, we have examined numerous

local program initiatives for the purpose of identifying criteria by which to select

sites. We are presently working on selecting a focal group of well-grounded, wellVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00098 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
95

implemented projects for in-depth evaluation to document their efficacy in delaying

sexual activity among teens and in promoting abstinence until marriage.

There is a wide range of programs being supported through Section 510 of Title

V. Funded activities range from state-level media campaigns to high-intensity,

multifaceted and multiyear youth development initiatives. A handful of states have

opted for a single statewide intervention strategy, but most have chosen to fund a

diverse set of initiatives. These initiatives range from brief, curriculum-based classroom programs that are offered community-wide, to more extensive classroom programs complemented by strong ‘‘boosters’’ to reinforce the abstinence messages delivered in the classroom and to provide youths with alternatives to high-risk behaviors. Many states also support community-wide abstinence-only initiatives, which attempt to alter youths’ behaviors through systemic changes in community norms, opportunities, and support.

I cannot speak to the states’ implementation of the Title V Abstinence Education

program. However, in the course of our preliminary work to design the evaluation,

we have observed a wide range of initiatives. The following five programs illustrate

some of the efforts that we have observed:

A locally designed program in Florida has developed an abstinence-only curriculum that is offered to youth in grades 6 through 12 as a yearlong elective class

that meets five days per week. Students receive an unequivocal message about the

value of abstinence, the power of building positive relationships, and the strong benefits of marriage. The classroom curriculum is reinforced and extended to encourage

parent support by regular home visits by social workers.

Another very intensive program, operating in New Jersey, follows a leading national abstinence-education program model. This school-based program offers a

multifaceted youth development curriculum with long-term adult involvement. It

provides girls with between 100 and 200 hours of interaction with responsible adult

mentors, most of whom are teachers, over a minimum of three years. In addition,

the program includes health and fitness components and it offers a structured curriculum covering topics such as friendship, decision-making, love and dating, selfrespect, and substance abuse.

In several Wisconsin middle schools, there is a program that works with youth

for two hours every day after school. This program delivers strong abstinence messages every day through a variety of means, including a formal curriculum that emphasizes knowledge of anatomy, information about sexually transmitted diseases

and the values of marriage, and positive skill-building activities such as job shadowing and exposure to cultural events and positive social engagements. Youths generally stay in the program throughout their middle school years. Moreover, for many

youths, program activities may extend into the summer, when the abstinence curriculum and youth development activities extend to all day, five days a week.

Virginia has a program for 8th and 10th graders that uses a nationally marketed

abstinence-education curriculum. The program classes, which meet about 30 times

a year, address abstinence in the context of a curriculum strongly focused on character development. The school-based abstinence education efforts are bolstered by

media campaigns, an information and referral service, and community workshops.

‘‘Booster’’ activities to reinforce the abstinence messages and abstinence-promoting

and enabling skills are instituted for the 9th graders.

And, Texas has a countywide initiative reaching students in more than two dozen

school districts with a national abstinence education curriculum. This program has

trained nearly 200 teachers to deliver the school-based curriculum; engages physicians, counselors, and abstinence resource specialists for ‘‘hot-lines’’ to answer questions about sexually transmitted diseases and other health risks associated with

teen and out-of-wedlock sex; produces and airs major media ‘‘spots′′; developed and

administered tools to train medical professionals in the promotion of abstinence; organizes community mentoring programs for youth that promote abstinence; and has

established local monitoring and assessment efforts to guide community planning.

In light of the breadth and depth of programs supported through the Title V Abstinence Education program, the evaluation will provide the much-needed evidence

regarding the potential of abstinence-only education strategies to promote abstinence and other positive behavioral choices by our young people. Moreover, the richness of program designs and the variability in the implementation settings will facilitate identifying model programs that are well suited to varying local circumstances—for example, for communities willing to institutionalize programs in

their schools versus those where it is most viable to situate programs in after-school

or community settings.

As others have documented in their testimony, the issues of teenage sex and out

of wedlock childbearing are extremely important. We need to expand effective policies to reduce both. For this reason, we have committed to the most rigorous standVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00099 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
96

ards for conducting the Title V Abstinence Education program evaluation. We will

rely on experimental design studies with large samples of youth to document the

impacts of various programmatic strategies on youths’ behaviors, knowledge, and attitudes. This rigorous impact analysis will be complemented by extensive qualitative

research that documents the nature of the interventions; the circumstances and

strategies for their successful replication; and the mechanisms through which programs can strengthen family values and responsible decision-making among youth.

Maynard.

Chairman JOHNSON of Connecticut. Thank you very much, Ms.

f

Ms. Miller.

STATEMENT OF BRENDA RHODES MILLER, DEPUTY DIRECTOR, NATIONAL CAMPAIGN TO PREVENT TEEN PREGNANCY

Ms. MILLER. Good morning. Thank you for inviting me to testify

on the relationship between teen pregnancy prevention and reducing nonmarital births. I am especially pleased by your invitation

because you are a member of our bipartisan House advisory panel.

I am deputy director of the National Campaign to Prevent Teen

Pregnancy, which is a privately-funded, nonprofit, nonpartisan organization here in Washington. It is clear from all we have heard

this morning that we must make it possible for all young people

to spend their teenage years on education, growing up and enjoying

their youth, not on rushing into adult situations and assuming

adult responsibilities.

Teen pregnancy affects not only the health and well-being of babies born to teens but also the young parents themselves, their

families and the community at large. The relationship between

teen pregnancy and nonmarital births is stark. Nearly three quarters of teen births are to unmarried teens, while as recently as

1960 only 15 percent were. Teens account for approximately 30 percent of all nonmarital births in the United States but nearly half

of all nonmarital first births.

I want to depart from my written testimony briefly to tell you a

little bit about two areas of the campaign’s work that we think are

especially useful in the area of reducing teen pregnancy in America. One area is our work including young people in the prevention

conversation and the other area is our work with the entertainment media to change social norms.

First, let me tell you I stand in awe of the wisdom and the energy of American teenagers. At the National Campaign to Prevent

Teen Pregnancy, we think it is enormously important for us to listen to young people because teens are the least represented in

terms of having their voices heard in this area of prevention. We

know that many decisions are made that affect young people’s lives

without any information from them on how those decisions will

play themselves out or what the decisions will mean to them.

So last summer the campaign reached out to about 100 national

and local organizations for help in building our youth leadership

team. The response was amazing. We got more than 150 nominations and we selected 13 boys and 13 girls, 15 to 18 years old,

black, white, Latino, Asian and native American, from the 20

States with high teen pregnancy rates or small declines in the teen

97

pregnancy numbers. These are thoughtful, perceptive people who

have strong opinions about teen pregnancy prevention, opinions

they back up with their life experiences.

The team includes young people who lead True Love Waits

projects as well as young people who are peer educators at Planned

Parenthood. We have Girl Scouts and 4-H members, former gang

bangers, members of the YWCA, boys and girls clubs members,

computer experts, dancers. We have a mother and a father, both

of whom are doing their best to be good parents, while they work,

go to school, and try to grow into productive adults.

Their life experiences are powerful and telling. One young girl

explained what teen pregnancy meant to her community by showing a home video she had made and explaining that there used to

be dozens of girls who could dance each year as Hopi maidens, but

now there are only a few. What she was telling us was that teen

pregnancy has made a big impact on her community because there

are no more maidens to dance.

A young man—a really good looking young man—told us that he

is often challenged to explain why a tall, good looking jock like he

is would wait until he got married to have sex. His answer, which

was based on his religious beliefs, was spiced with a lot of humor.

He says that he tells people, I am just worth the wait.

We have learned from these kids that teenagers agree with most

adults, that teen pregnancy is not in anyone’s best interest, that

they want to talk to adults about feelings, about values, about love,

sex and relationships. Though we have also learned that a lot of

teenagers have nowhere to turn for information on these important

subjects.

Much of what we have learned from the teenagers in the youth

leadership team are in these two publications that I have provided

to you. We have done these in both English and Spanish. One of

them is talking back, 10 things teens want parents to know about

teen pregnancy, and the other one is thinking about the right now,

what teens want other teens to know about pregnancy prevention.

This leads me into the campaign’s work with the entertainment

media. We are a small shop. We realized early in the game that

there was no way we could reach all the audiences who needed to

be reached with the message that teen pregnancy is not OK. So,

rather than throw up our hands in dismay, we worked through our

media task force to deliver key messages about teen pregnancy prevention to our core audiences, which includes boys and girls, parents, other adults, opinion leaders. We brought in partners from

radio, television, magazines to help us deliver the prevention messages. We don’t beat the entertainment media over the head or

blame them for the problem. Rather, we enlist their support by providing them with facts, information and brainstorming ways we

can be helpful to them in presenting the prevention messages. We

work in true partnership and focus on communicating prevention

messages rather than on just getting visibility for ourselves.

Last year, we had briefings for seven TV shows in Hollywood, six

daytime dramas in New York and the producers of Black Entertainment Television teen’s summit here in Washington. As a result

at least seven of these television shows have incorporated campaign messages into story lines and episodes, and I will say it fast,

98

1 Brown, Sarah and Leon Eisenberg (ed), The Best Intentions: Unintended Pregnancy and the

Well-Being of Children and Families. Committee on Unintended Pregnancy. Institute of Medicine. Washington, D.C.: The National Academy Press, 1995. 2 Ibid.

7th Heaven, Dawson’s Creek, Party of Five, the Parenthood, Channel One, ER, and again, Black Entertainment Television.

We believe our work with the national entertainment media and

our work with young people have a lot in common. The campaign

continues to learn from both groups about what is important to

them and what will move them to act in preventing teen pregnancy

in America.

Thank you very much.

[The prepared statement follows:]

Statement of Brenda Rhodes Miller, Deputy Director, National Campaign to

Prevent Teen Pregnancy

Good Morning. Thank you for inviting me to testify on the relationship between

teen pregnancy prevention and reducing non-marital births. My name is Brenda

Rhodes Miller and I am Deputy Director of the National Campaign to Prevent Teen

Pregnancy and in the fall will lead a District of Columbia Campaign to Prevent

Teen Pregnancy.

I am especially pleased by the invitation because with the support of several people here, the Campaign has established two bipartisan advisory panels, one in the

Senate co-chaired by Joseph Lieberman (D–CT) and Olympia Snowe (R–ME) and

one in the House co-chaired by Nita Lowey (D–NY) and Mike Castle (R–DE). The

House Bipartisan panel has initiated a number of special projects with the National

Campaign. Indeed, the chair of the subcommittee on human resources, Representative Nancy L. Johnson, is an active member of the house advisory panel and I thank

her for including me in today’s proceedings.

It is clear that we must make it possible for all young people to spend their teenage years on education, growing up and enjoying their youth, not on rushing into

adult situations and assuming adult responsibilities. Teen pregnancy affects not

only the health and well being of babies born to teens, but also the young parents

themselves, their families, and the community at large. The relationship between

teen pregnancy and non-marital births is stark. Nearly three quarters of teen births

are to unmarried teens while as recently as 1960 only 15% were. Teens account for

approximately 30% of all non-marital births in the United States but nearly half

of all non-marital first births.

THE CRITICAL IMPORTANCE OF REDUCING TEEN PREGNANCIES TO CHILD HEALTH AND

WELL-BEING

The National Campaign to Prevent Teen Pregnancy was organized in 1996 by individuals who concluded, for a variety of reasons, that reducing the nation’s rate of

teen pregnancy was one of the most strategic and direct means available to improve

overall child well-being and to reduce persistent child poverty. Although the Campaign’s activities often bring it into collaborative working relationships with those

in the reproductive health field, the Campaign should be seen, first and foremost,

as an intense effort to strengthen child health and welfare.

Teen pregnancy and child-bearing go hand in hand with heavy health risks for

mother and child. Young adolescents (particularly those under age 15) experience

a maternal death rate 2.5 times greater than that of mothers aged 20–24. Common

medical problems among adolescent mothers include poor weight gain, pregnancyinduced hypertension, anemia, sexually transmitted diseases (STDs), and

cephalopelvic disproportion. Later in life, adolescent mothers tend to be at greater

risk for obesity and hypertension than women who were not teenagers when they

had their first child.1 Moreover, the children of teen mothers are at a significantly

increased risk of at least the following: low birth weight and prematurity, mental

retardation, insufficient health care, inadequate parenting, abuse and neglect, poverty, growing up without a father, and poor school performance.

Low birth weight and related health problems: Infants born to mothers 15 yearsold or younger are more than twice as likely to weigh less than 5.5 pounds at birth

and three times more likely to die in the first 28 days of life than infants born to

older mothers.2 Low birth weight raises the probabilities of infant death, blindness,

deafness, chronic respiratory problems, mental retardation, mental illness, and cereVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00102 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
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3Maynard, Rebecca (ed), Kids Having Kids: A Robin Hood Foundation Special Report on the

Costs of Adolescent Childbearing, New York: Robin Hood Foundation, 1997; See also Wolfe, Barbara and Maria Perozek, ‘‘Teen Children’s Health and Health Care Use,’’ in Kids Having Kids:

Economic Costs and Social Consequences of Teen Pregnancy. Rebecca A. Maynard (ed). Washington, D.C.: The Urban Institute Press, 1997. 4Maynard, Rebecca (ed), Kids Having Kids: A Robin Hood Foundation Special Report on the

Costs of Adolescent Childbearing, New York: Robin Hood Foundation, 1997; See also Wolfe, Barbara and Maria Perozek, ‘‘Teen Children’s Health and Health Care Use,’’ in Kids Having Kids:

Economic Costs and Social Consequences of Teen Pregnancy. Rebecca A. Maynard (ed). Washington, D.C.: The Urban Institute Press, 1997. 5 Ibid.

6 Carnegie Task Force on Meeting the Needs of Children, Starting Points: Meeting the Needs

of Our Youngest Children, Carnegie Corporation of New York, August, 1994. 7Maynard, Rebecca (ed), Kids Having Kids: A Robin Hood Foundation Special Report on the

Costs of Adolescent Childbearing, New York: Robin Hood Foundation, 1997; See also Goerge,

Robert M, and Bong Joo Lee, ‘‘Abuse and Neglect of the Children,’’ in Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy. Rebecca A. Maynard (ed). Washington,

D.C.: The Urban Institute Press, 1997. 8 Ibid.

9 Brown, Sarah and Leon Eisenberg (ed), The Best Intentions: Unintended Pregnancy and the

Well-Being of Children and Families. Committee on Unintended Pregnancy. Institute of Medicine. Washington, D.C.: The National Academy Press, 1995.

bral palsy. In addition, low birth weight doubles the chances that a child will later

be diagnosed as having dyslexia, hyperactivity, or another disability.3

Insufficient health care: Despite having more health problems than the children

of older mothers, the children of teen mothers receive less medical care and treatment. In his or her first 14 years, the average child of a teen mother visits a physician and other medical providers an average of 3.8 times per year, compared with

4.3 times for a child of older child bearers.4 And when they do visit medical providers, more of the expenses they incur are paid by others in society than is the

case among children of older mothers. One recent study suggested that the medical

expenses paid by society would be reduced dramatically if teenage mothers were to

wait until they were older to have their first child.5

Inadequate parenting: Children born to teen mothers are also at higher risk because their mothers—and often their fathers as well—are typically too young to

master the demanding job of being a parent. Still growing and developing themselves, teen mothers are often unable to provide the kind of environment that infants and very young children require for optimal development. Recent research, for

example, has clarified the critical importance of sensitive parenting and early cognitive stimulation for adequate brain development.6

Abuse and neglect: Children of adolescent parents also suffer higher rates of

abuse and neglect than would occur if their mothers had delayed childbearing. For

example, a recent analysis found that there are 110 reported incidents of abuse and

neglect per 1,000 families headed by a young teen mother. If these mothers had delayed childbearing until their early twenties, this rate would be less than half this

level—or 51 incidents per 1,000 families.7 Similarly, rates of foster care placement

are significantly higher for children whose mothers are under 18. In fact, over half

of foster care placements of children with these young mothers could be averted by

delaying child-bearing, thereby saving taxpayers nearly $1 billion annually in foster

care costs alone.8

Poverty and single parenthood: Preventing teen pregnancy is also important because of its persistent link to poverty and other social ills. The growth in single parent families remains the single most important reason for increased poverty among

children. Given that out-of-wedlock childbearing is currently the driving force behind the growth of single parents and that half of first out-of-wedlock births are to

teens, reducing teen pregnancy and child-bearing is an obvious place to anchor any

serious effort to reduce poverty in future generations. And since more than three

quarters of unwed teen mothers end up on welfare, it is also a good way to reduce

welfare dependency and its costs to society.

School performance: Compared with children from the same background who grow

up with both biological parents, children raised in single-parent households are

more likely to drop out of high school, less likely to attend college, and less likely

to graduate from college if they attend. Before leaving high school, children from

single-parent homes score lower on standardized achievement tests, have lower

grade point averages, have more erratic attendance records, and have lower college

expectations. These children also show more behavioral and emotional problems

while growing up, as reported by parents and teachers.9

The bottom line: One of the reasons that this country continues to struggle with

seemingly intractable poverty and social burdens is that, at present, over 40 percent

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of first births in this country are to women with one or more of the following attributes: being under 20, unmarried, and/or lacking a high school diploma. If we can

reduce this figure substantially (as we would if teen pregnancy alone were reduced—these three measures are highly interrelated), we can anticipate significant

overall improvement in a whole range of problems that now burden us, from poor

health to school failure to poor job skills. We understand that poverty is a cause

as well as a consequence of teen pregnancy, and we try constantly to help people

understand the connection. But while we all wait for an effective national assault

on poverty, we urge attention to a more focused and immediate goal: reducing teen

pregnancy.

In essence, we’re trying to get at one of the major sources of our enduring social

problems—children having children. As such, we are working on a two generational

agenda. And although we understand that there is still some controversy (within the

research community) about how much a reduction in teen childbearing would improve the lives of young women themselves, there is no question about the benefits

that children realize when they have mothers—and, hopefully, fathers, too—who are

ready to assume the responsibilities that being a parent entails. Although reducing

teen pregnancy obviously would not eliminate all our social ills, it would move us

forward significantly.

It’s important to add, incidentally, that working to reduce rates of teen pregnancy

is not a quixotic quest. Lower rates of teen pregnancy and child-bearing are reported

in all of the other industrialized countries to which the United States typically compares itself, and the fact that U.S. rates have fluctuated significantly over this century shows that they are not set in stone. Moreover, declines since 1991 in both the

teen birth and teen pregnancy rates demonstrate that U.S. rates can decrease steadily; although these rates are still very high (even above those in the 1980s), we

should all be encouraged by the recent good news and motivated to take the additional steps necessary to sustain the downward trend.

THE CAMPAIGN’S STRATEGY

The Campaign’s program and strategy over the next three years are based on two

key goals: (1) strengthening social norms through our own actions and those of others; and (2) creating a national movement through better coordinated and supported

state and local efforts. In both of these areas, the Campaign serves as a catalytic

group emphasizing highly leveraged activities that complement and extend the programmatic solutions to teen pregnancy emphasized by other groups.

Strategy #1.—Strengthening Social Norms

The Campaign has become convinced that one of the main reasons that we have

high rates of teen pregnancy in the United States is that the nation lacks clearly

articulated social norms and expectations that would lead to reduced rates of teen

pregnancy. In particular, influential groups and individuals rarely speak clearly and

forcefully against teenaged pregnancy, or about expected standards of adolescent

sexual behavior. Even though polling data and survey research reveal an impressive

national consensus in both of these areas, this consensus is often obscure or, at

worst, invisible. Accordingly, the Campaign is giving major strategic priority to articulating and strengthening the underlying national consensus regarding both

these issues.

With regard to the first norm, although few are in favor of teen pregnancy and

child bearing, the adults in this country seem oddly reluctant to state crisply and

often that adolescence is for education and growing up, not pregnancy and parenthood, that children need adult parents, and that pregnancy and parenthood at a

young age is in no one’s best interest. Adults seem to hedge about this, fearful of

hurting feelings, of devaluing those who have born children in their teens, of making a values-based statement.

In the Campaign’s view, this reluctance to speak clearly against teen pregnancy

contributes directly to the high levels of non-marital teen pregnancy that the nation

is currently experiencing. In the absence of well-articulated standards, social norms

and expectations, it is all too easy for young people to fail to do one of the only two

things that will avoid pregnancy—abstaining or using contraception extremely carefully. Both take motivation and work, and both rest on some sort of basic conviction,

belief or value. In a culture that fails to speak clearly about whether teen pregnancy

is or isn’t okay, how can we be surprised if so many pregnancies occur?

It is therefore critical that there be more explicit and powerful articulation of the

basic concept that non-marital teen pregnancy and childbearing are in no one’s best

interests. The clear, unambiguous message must be that at this time, in this country, in this economy with its ever-rising requirements for an educated work force,

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the adolescent years must be used for education, skill-building and maturation. As

alluded to earlier, recent research on early childhood development in the first weeks

and months of life shows ever more conclusively the critical need that infants have

for adult parents able to provide irreplaceable stimulation, stability and care early

in life. All children need parents who are ready to take on the most important responsibility that any adult undertakes. Pretending otherwise—or worse, not speaking directly about all this—serves no good end.

New efforts must also be made to give voice to a second strong national consensus

that is not well articulated, especially at the national level: teenagers should abstain

from sex during the school years; those who become sexually active, however, should

have access to contraception. In a 1997 poll conducted by the Campaign, 95% of both

adults and teens agreed that society should give kids a strong message that they

should abstain from sex at least until they are out of high school. There is no ambiguity about this shared national value. As is well known, however, not all teens are

going to achieve this standard and therefore a majority of Americans also support

the notion that sexually active teenagers should have ready access to contraception.

But the acceptance of contraception seems grounded in a clear preference for abstinence as the desired standard of behavior.

At the Campaign, we approach this task at two levels: what the Campaign itself

can accomplish with our own resources to strengthen these two points of consensus,

and what the Campaign can encourage other groups and social sectors to undertake

as a result of our leadership.

What the Campaign itself can do: The Campaign increasingly threads these two

social norms throughout all our work. We include them in our publications, advocacy, conferences, and seminars. And in particular, we express them in our frequent

contacts with the press and in our work with media leaders. We do not shy away

from taking clear positions on both of these issues, and we seek opportunities to

state them crisply and publicly. We believe that our willingness to address social

norms and to discuss values is one of the Campaign’s unique characteristics, absent

from most other groups working on this and related topics. Were we to ignore the

values dimension of the problem, we believe our strategy would be missing one of

the core challenges in reducing teen pregnancy.

Is the Campaign’s focus on values and social norms useful? We can only report

that we have been stunned by the power of our position. In speech after speech, in

media briefing after media briefing, in community after community, we hear constantly that our taking an unambiguous stand in these two areas is not only powerful, but also unusual. One woman in Atlanta said to the Campaign’s director recently, ‘‘I’ve worked in this field now for over ten years, and I don’t ever recall anyone or any group offering such straight talk [sic]. Don’t you ever get in trouble?’’

Well, so far, no. We are amazed that taking a clear stand can be valuable in and

of itself, particularly if the position resonates with the majority of Americans, as we

believe ours does.

What other groups can do: As intent as the Campaign is on giving new voice to

these basic ideas and values ourselves, we remain a very modest organization with

a small staff and budget. Obviously, the challenge of influencing and clarifying social norms is enormous and will require the efforts of many groups. Accordingly, the

Campaign invests heavily in urging other groups and social sectors to act. That is,

the Campaign has very consciously adopted a ‘‘high-leverage’’ approach to extend its

influence and reach far more groups and individuals than it ever could reach on its

own.

At present, we are working hard to enlist the interest and help of the entertainment media and we are also reaching out to parents and other adults deeply involved in the lives of young people. We are especially proud of our work with young

people themselves and faith communities.

(a) The entertainment media: One of the most efficient ways to communicate with

the nation about social norms or any other topic is through the media, especially

the entertainment media, which is a pervasive force in American life and a major

arbiter of culture. The ability of the media to convey information, shape values, and

influence attitudes is well known. Recognizing how powerful this sector can be, especially if it were to be enlisted in reducing teen pregnancy, the Campaign is placing its highest priority on work with the entertainment media, both print and

broadcast.

With the help and leadership of our Media Task Force, we are now working productively with a wide variety of media groups. Rather than taking the traditional

public service announcement (PSA) route, which can have limited reach and unpredictable viewership, we instead are working in partnership with entertainment

media leaders, offering each a menu of ideas and messages that we ask them to

weave into their story lines over time. Many young people pay close attention to

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10Miller, Brent. (1998). Families Matter: A Research Synthesis of Family Influences on Adolescent Pregnancy. Washington, DC: The National Campaign to Prevent Teen Pregnancy.

what their favorite characters on television say and do, and many parents feel that

the media can and should echo the prevention messages they are trying to teach

at home. By working with decision-makers in many parts of the entertainment

media industry, the Campaign is reaching a wide variety of audiences with important prevention messages delivered in ways that are appealing and memorable to

them.

(b) Parents: In spring of 1998, the Campaign emphasized another approach to reducing teen pregnancy that is rarely spotlighted: encouraging parents and adults

generally to take a more active role in supervising and communicating with their

children about a wide range of issues related to sex, love and relationships. We published a review of 20 years of research about the powerful role that families play

in reducing sexual risk-taking,10 and translated these findings into Ten Tips for

Parents to Help Their Children Avoid Teen Pregnancy.

(c) Youth themselves: In January 1999, 26 outstanding young people, (13 boys and

13 girls), from all over America joined the National Campaign to form the Youth

Leadership Team. Nominated by organizations across the country, the Youth Leadership Team advises the Campaign and gives voice to the unique perspectives and

opinions of teens. They represent 20 states and organizations ranging from Best

Friends to 4-H to Planned Parenthood to the YWCA to the Girl Scouts to the Mexican American Community Services Agency to the United Way. The Youth Leadership Team meets twice annually and has contributed to recent Campaign publications including Talking Back: Ten Things Teens Want Parents to Know About Teen

Pregnancy and Thinking About the Right-Now: What Teens Want Other Teens to

Know About Preventing Pregnancy.

(d) Faith Communities: Given the pervasiveness of religious organizations and the

large number of Americans affiliated with an organized religion, the deep religiosity

of this country, the important role that values and moral choices make in sexual

behavior, and the growing concern among religious leaders about the state of the

American family, the Campaign has reached out through Nine Tips to Help Faith

Leaders and Their Communities Address Teen Pregnancy, (written by the Campaign’s Task Force on Religion and Public Values) and through a series of regional

meetings for faith leaders. The religious community is large, powerful, and one of

the most influential centers of leadership in the country. Our goal in working with

faith community leaders will be to enlist their interest in preventing teen pregnancy, to learn how they are already supporting families and teenagers themselves,

and to explore ways that the Campaign can support their efforts.

Strategy #2.—Creating a National Movement Through Strengthened and Better Coordinated State and Local Efforts

The Campaign matches its ‘‘top down,’’ high-leverage efforts just described with

a strong focus on creating a ‘‘bottom up’’ national movement. We do so by providing

state and local programs, coalitions, and leaders with a wide variety of materials,

ideas, and hands-on assistance and encouragement.

Linking state and local efforts: Over the last three years the Campaign has

learned that although many states and communities have various coalitions and

programs to reduce teen pregnancy, they are generally quite fragile and disconnected from one another. They are rarely based on strong theory or solid research,

and there are few mechanisms in place for people to learn what others are doing

in their own state and around the country. In response, the Campaign is trying to

bolster state and local efforts in a variety of ways: through technical assistance, by

producing and disseminating research-based publications, and by holding conferences and meetings for individuals at the state level. We have also developed an

interactive bulletin board on our web site that allows state and local practitioners

to communicate directly with each other and the Campaign about new strategies,

points of interest, and upcoming events. (The idea for this originated at the Campaign’s state-based media conference in June 1997, where participants from 41

states lamented the lack of connection among state practitioners working in teen

pregnancy prevention.) In these disparate ways, our objective is to foster a national

movement from a set of often disconnected parts.

The Campaign also continues to visit states and local communities (more than 40

states at last count) to learn more about what they are doing and what problems

they have encountered, as well as to communicate new ideas about preventing teen

pregnancy. At these ‘‘site visits,’’ the Campaign meets with local leaders, talks with

teenagers, learns more about coalition-building and local programs from the people

‘‘on the ground’’ who are doing the work. In addition, the Campaign shares ideas

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gleaned from visits and consultations all over the country as a way to connect teen

pregnancy prevention efforts nationwide.

While the states and local communities first and foremost want more money to

fund their work, their second major request is for technical assistance with their

specific challenges they face in planning and implementing prevention initiatives.

In response, the Campaign provides ongoing help to communities in working

through problems and identifying resources of all kinds. Most recently, Campaign

staff provided individuals working in states and communities with a list of suggested activities for Teen Pregnancy Prevention Month in May. As a result, a number of states organized linked activities and events.

Tool kit: A major component of our work with states and communities involves

the release of a practical, ‘‘user-friendly’’ tool kit for states and communities searching for ways to reduce teen pregnancy in their areas. Developed in close consultation

with our Task Force on State and Local Action, this tool kit provides concise tips

for communities on how to develop teen pregnancy prevention programs and partnerships. It includes information on what is needed to develop a sustainable program and what its activities might usefully include. Information targets, for example, how to handle the conflict that work on this problem often generates, how to

involve youth in community programs and planning, and how to conduct a review

of the evidence on promising programs.

Conflict reduction: In our work with states and communities, we give special emphasis to conflict reduction, quite simply because so many local and state leaders

have reported that controversy and divisive publicity too often greet bold actions to

reduce teen pregnancy—and that the controversy and hostility can spring from right

or left, depending on the solution being advocated. We have been so struck by the

tensions in this area that we have developed a saying in the office that captures

the problem: while the adults are arguing, the kids are getting pregnant. In our

view, unless communities can find new ways of doing business in this field—ones

that are less prone to eruptions, blow-ups, and angry editorials in the newspaper—

we will continue to be limited in our ability to decrease teen pregnancy.

Under the guidance of the Campaign’s Task Force on Religion and Public Values,

we have developed an approach to community conflict that is designed to reduce

tensions and allow progress. This community process (called ‘‘structured community

dialogues,’’ or SCDs) was recently piloted in California. With Campaign leadership

and guidance, a group of community leaders in San Bernardino active in teen pregnancy prevention engaged in a two-day SCD that increased mutual tolerance and

helped the participants to build areas of common ground and action. The Campaign’s publication, While the Adults are Arguing: The Teens Are Getting Pregnant

was produced following the San Bernardino meeting. Subsequent to the San

Bernardino pilot, a similar meeting took place in Glendale, Arizona with tremendous community support. A goal is to use this same approach in three or four other

communities in order to demonstrate the value of this model for breaking deadlocks

at the community level.

CONCLUSION

We’re often asked to summarize briefly the Campaign’s overall approach. Here’s

the briefest summary statement we’ve yet devised:

The United States has the highest rate of teen pregnancy in the industrialized world. Two-fifths of our teenaged girls become pregnant before their

twentieth birthday. Almost half of first births today are to mothers who are either teens, unmarried, or lacking a high school degree. This does not auger well

for the future of our economy or our society.

This dismal situation is unlikely to improve significantly without clearly articulated social norms and expectations that discourage teenage pregnancy.

Young people today are heavily influenced by the media and by peer group pressures that romanticize sex and child-bearing, and they are spending less time

with parents or other responsible adults who could counter such influences.

There is a consensus in this country that non-marital teen pregnancy is not

acceptable or ‘‘okay,’’ and that teens should delay sex and pregnancy at least

through high school, although the public wants contraception to be available to

those who need it. The Campaign’s goal is to strengthen and clearly articulate

these points of consensus through our own efforts and with the help of such

other powerful sectors as the media, faith leaders and youth themselves. We

also seek to support and honor other organizations whose programmatic efforts

in this area are most effective, and to build a national movement to reduce teen

pregnancy out of a myriad of smaller efforts at the state and local levels. In

104

all these activities, we seek to decrease unproductive conflict and help all to find

areas of common ground and common action.

preciate that.

Thank you.

Chairman JOHNSON of Connecticut. Thank you, Ms. Miller. I apf

Mr. Tetelman.

STATEMENT OF EDWARD TETELMAN, ASSISTANT COMMISSIONER, NEW JERSEY DEPARTMENT OF HUMAN SERVICES

Mr. TETELMAN. Thank you for inviting me. I am Ed Tetelman.

I am the assistant commissioner for the Department of Human

Services, and I am pleased to discuss this important topic with you.

In New Jersey, we have been fortunate to have clear leadership

from our governor Christie Whitman on the problems related to

teen pregnancy and nonmarital births. Most New Jersey teens who

give birth are unmarried or in marriages that don’t last very long.

New Jersey’s teen pregnancy rate is 35 per 1,000 births as compared to the national average of about 54 per 1,000.

In New Jersey, our efforts to prevent teen pregnancy range from

the creation of an 800 number that teens can call to find out about

family planning services to developing a pool of mentors who impart information and a message that sometimes unfortunately just

doesn’t come from parents.

Let me tell you a little bit about the specifics of these programs.

Last year, Governor Whitman directed $1 million, TANF dollars, to

an adolescent pregnancy prevention initiative. That initiative includes a strong mentoring effort. I want to thank the committee for

granting the States the flexibility with TANF funds to making this

program possible. If we didn’t have that flexibility, we wouldn’t be

able to do this.

In our first mentoring program we have adults working with

teens at risk of becoming pregnant. These adults provide counseling and family planning information, but probably the most important thing they do is to—and the hardest to measure is that

they help to build self-esteem. They help teens learn how to make

decisions for themselves, and they encourage a young woman to

look beyond today. A caring adult can have a profound influence on

a teenage girl as she struggles to define her own self-image.

Our second mentoring program uses teen mentors, and they provide similar information about family planning and related health

issues. Peer pressure among teens is especially intense. Its influence often results in teens making poor or self-destructive decisions

based on bad or no advice. We realize that the carrier of the message can be as important as the message itself.

Another initiative is the governor’s allocation of $100,000 to create an 800 number hotline that provides counseling referrals to

teens who are weighing practical decisions around sex and related

health issues. Also, our counselors advise that abstinence is the

only guaranteed way of preventing pregnancy or avoiding a sexually transmitted disease.

105

To publicize these prevention efforts, last year we undertook a

public relations campaign. As a result, the hotline calls increased

by 600 percent. One of the reasons New Jersey was able to develop

these programs so quickly is that we had some solid experience to

draw on from our school-based youth services program. This program offers comprehensive service on a one stop shopping basis in

or near schools. The core services of employment, mental health

and family counseling, healthcare, counseling and family planning,

as well as recreation and information and referral.

The staff develop relationships based on trust, and from that relationship they are able to provide teens with the ability to express

their feelings so that if they want to say no to sex they can. However, if they are engaged in sex, they receive the information they

need to protect themselves.

Our school-based program has shown dramatic reductions in adolescent pregnancies and repeat pregnancies. At one of our schoolbased sites there had been on the average about 20 teen births a

year. After our program began providing counseling and family

planning service that number dropped to three pregnancies or less

a year at the high school, remaining so for over 8 years. The keys

to success are connections and collaborations between educators,

counselors, healthcare providers with teens at the ground level.

As part of our most recent effort to enhance prevention efforts,

Governor Whitman held regional forums on the prevention of adolescent pregnancies, including teens. Additionally, the Governor

has established an Advisory Council on Adolescent Pregnancy that

represents varied opinions in the field.

We have learned a number of lessons from our teen pregnancy

programs. First, school-based programs work, and second, that

there was a correlation between the numbers of births to a teen

and her age. We concluded that as we develop programs we must

consider the different dynamics that lead to pregnancies in girls

under 14 years of age and those between 17—15 and 17 and those

between 18 and 19 years old, where in New Jersey it is the bulk

of the young women getting pregnant, about 6,000.

We noted that in all successful programs that collaboration and

coordination was the key. We also established to carry this out an

interdepartmental work group on adolescent pregnancy. This group

developed county teen pregnancy initiatives, coordination that

looked at existing programs to get the message through our existing programs, as Dr. Nathan says, Medicaid, school to work and

those types of programs, and a public relation campaign that includes public service announcements for movie theaters, as well as

TV and radios. The 30-second spot will be viewed before PG and

R movies and will spread our prevention message to a teenage audience. Additionally, there are wallet-sized cards with pertinent information and posters to promote the hotline.

I would like to close with just a brief discussion on the role of

TANF dollars in the prevention of pregnancy. No. 1, TANF dollars

pay for our mentoring programs. TANF dollars also support our

child care efforts in 11 highly successful adolescent parent programs that are located in schools throughout the State with high

pregnancy rates. These programs have almost no repeat pregnancies and close to 100 percent graduation rates. By the way,

106

most of those young women go on to jobs and college. The programs

assist teen moms to stay in school as required also by the TANF

regulations themselves.

TANF dollars have also been used to leverage other dollars from

other sources, from foundations and Children’s Trust Fund.

And in closing, New Jersey is committed to reducing teen pregnancy. The welfare reform message of personal responsibility, along

with the flexible use of Federal dollars, has allowed us to take important steps to address this issue. We all recognize this is not just

a welfare issue and that we must continue to engage parents, government, business, educators, the community and faith-based organizations, as well as teens. Obviously, we still have a lot of work

to do to reduce teen pregnancy, and New Jersey is committed to

the goal.

Finally, your focus on teen pregnancy prevention and nonmarital

births today highlights your commitment to breaking the cycle of

welfare dependency and ultimately giving a young person an opportunity to make choices in their best interest. Thank you very much.

[The prepared statement follows:]

Statement of Edward Tetelman, Assistant Commissioner, New Jersey,

Department of Human Services

Thank you for inviting me to speak with you today. I am Ed Tetelman, Assistant

Commissioner of the New Jersey Department of Human Services. I am pleased to

be with you as we discuss this important topic.

In New Jersey, we have been fortunate to have clear leadership from our Governor, Christie Whitman, on the problems related to teen pregnancy and non-marital births.

Most New Jersey teens who give birth are unmarried, or are in marriages that,

in many instances, won’t last.

New Jersey’s teen pregnancy rate is 35 per 1,000, as compared with the national

average of 54 per 1,000.

In New Jersey, our efforts to prevent teen pregnancy have ranged from the creation of an 800 number that teens can call to find out about family planning services to developing a pool of mentors who impart information and a message that

sometimes, unfortunatey, just doesn’t come from a parent.

Let me tell you a little bit about the specifics of our programs.

Last year, Governor Whitman directed $1 million in TANF dollars to an Adolescent Pregnancy Prevention Initiative. I want to thank the committee for granting

states flexibility with tanf funds making this program possible.

The initiative includes a strong mentoring approach. First, we have adults working with teens at risk of becoming pregnant. These adults provide counseling and

family planning information. But probably the most important thing they do is the

hardest to measure. They help build self-esteem, and help teens learn how to make

decisions for themselves. They encourage the young woman to look beyond today.

A caring adult can have a profound influence on a teenage girl as she struggles

to define her own self image.

Our second mentoring program is similar with one key difference: the mentors are

teenagers themselves. They provide similar information about family planning and

related health issues.

Peer pressure among teens is especially intense. Its influence often results in

teens making poor or self destructive decisions based on bad or no information.

We realized that the carrier of the message can be as important as the message

itself.

Another initiative is the governor’s allocation of $100,000 to create a toll-free hotline that provides counseling and referrals to teens who are weighing practical decisions about sex and related health issues.

Our counselors advise that aBstinence is the only guaranteed way of preventing

pregnancy or of avoiding a sexually transmitted disease.

To publicize our prevention efforts, Last year we undertook a public relations

campaign. As a result, calls to the hotline have continued to climb as this campaign

has gained momentum. We have seen a greater than 600 percent increase in calls

since we began the campaign.

107

One of the reasons New Jersey was able to develop these programs so quickly is

that we had some solid experience to draw on with our school-based youth services

program.

This program offers comprehensive services on a one-stop shopping basis in or

near schools. The core services include employment services, mental health, family

counseling, and health services, including family planning and counseling.

The staff develop relationships based on trust. From that relationship, they are

able to provide teens with the ability to express their feelings so that if they want

to say no to sex, they can.

However, if they are engaged in sex, they receive the information they need to

protect themselves.

Our school-based program has shown dramatic reductions in adolescent pregnancies and repeat pregnancies.

At one of our school based sites, there was on average about 20 teen births each

year. After our program began providing counseling and family planning services,

that number dropped to three pregancies or less each year at the high school—

remaining so for over eight years. the keys to success are the collaborations that

are developed between educators, counselors and health providers with the teens

from the outset.

As part of our most recent effort to enhance prevention efforts, Governor Whitman

held Regional forums on the prevention of adolescent pregnancy.

Additionally, the governor has established an Advisory Council on Adolescent

Pregnancy that represents the varied opinions of those in the field.

We have learned a number of lessons from our teen pregnancy programs.

First, there have been extraordinary reductions in births to teens in some of our

School-Based Youth Service Program sites; and second, there is a corrolation between the numbers of births to a teen and her age.

We concluded that as we develop programs, we must consider the different dynamics that lead to pregnancies in girls under 14 years of age (fewer than 350 a

year), those 15 to 17 years (3,500) and those 18 and 19 years old (6,000).

We noted that in all successful programs, the local educators, health providers,

and mental health and employment counselors were working in a coordinated fashion and made great efforts to create a seamless connection to provide necessary

services.

Accordingly, collaboration and coordination became key to New Jersey’s efforts.

We established an inter-departmental WorkGroup on Adolescent Pregnancy Prevention. Senior representatives from the New Jersey Departments of Education,

Health and Senior Services, Labor, Community Affairs, Child Abuse Prevention and

Juvenile Justice participated. Following are some of the activities this group helped

to organize:

• County-based teen pregnancy prevention efforts. These programs were developed locally by educators, service providers, business representatives, government

officials, and most importantly, teens.

• Coordination with other state programs, such as paternity support, Adolescent

Health, the Abstinence grants of the NJ Dept. of Health and Senior Services, Medicaid, school-to-work, housing, domestic violence, employment and training, and

youth and family services.

• A public relations campaign that includes Public service announcements for

movie theaters as well as TV and radio. The 30-second spot will be viewed before

PG and R movies and will spread our prevention message to a teenage audience.

I’d like to briefly discuss the role of TANF dollars in the prevention of pregnancy.

The 22 mentoring programs I spoke of earlier are supported with TANF dollars.

TANF dollars support childcare for 11 highly successful adolescent parent programs that are located in schools throughout the state with high pregnancy rates.

These programs have almost no repeat pregnancies and close to 100% graduation

rates. they assist teen moms in staying in school as required by the TANF regulations.

TANF dollars have also been used to leverage dollars from other sources. For example, children’s trust fund and foundation dollars pay for special programs for fathers and are used to expand mentoring to a larger number of youth.

In closing, New Jersey is commited to reducing teen pregnancy. The Welfare reform message of personal responsibility along with the flexible use of federal dollars

has allowed us to take important steps to address this issue. We all recognize that

this is not just a welfare issue and that we must continue to engage parents, government, business, educators, commumity and faith-based organizations, and, of

course, teens. We still have a lot of work to do to continue to reduce teen pregnancy,

and we remain committed to that goal.

108

We applaud the committee for examining the issue of non-marital births and look

forward to working with you in the future.

I would be happy to respond to any questions.

Chairman J

Mr. Sciamanna.

OHNSON of Connecticut. Thank you very much.

f

STATEMENT OF JOHN SCIAMANNA, SENIOR POLICY ASSOCIATE, AMERICAN PUBLIC HUMAN SERVICES ASSOCIATION

Mr. SCIAMANNA. Thank you, Madam Chair. My name is John

Sciamanna. I am a senior policy associate at the American Public

Human Service Association. Thank you for the opportunity to share

preliminary results of our survey on State efforts to reduce nonmarital births and in particular to prevent teenage pregnancy. I

will summarize my testimony.

The reduction of teenage pregnancy in nonmarital births are of

key concern to State health and human service directors. They

know that the prevention of teenage births will reduce future dependence on public assistance and poverty. The Personal Responsibility and Work Opportunity Reconciliation Act placed an emphasis

on reducing nonmarital births. In the 3 years since its passage

APHSA together with the Population Resource Center has sponsored national meetings to examine State strategies and programs

in out-of-wedlock births. The survey I will summarize for you today

is another in our efforts to highlight the importance of this issue

to our organization and to our members.

Since August 1996 the goal of State TANF programs has been on

moving families from welfare to work. States are also focusing attention on this issue by expanding past State health department efforts in initiating new TANF funded programs. Efforts to reduce

teen pregnancy is not limited to the TANF arena. It is a broader

issue that spans income groups and must be addressed by a comprehensive approach involving State and local parties, programs

and community-based organizations. It is key to the success of welfare reform that we address both the needs of adults on TANF as

well as the needs of their children, and preventing an unintended

pregnancy is part of that strategy.

I would like to share with the committee some of the initial information on State efforts that we have received so far. Thirty-six

States indicated to us that they are funding teen pregnancy or outof-wedlock birth prevention programs with either Federal TANF

funds or State maintenance of effort TANF funds. Nine of these

thirty-six are using TANF funds specifically for abstinence education efforts. Title V funds, as we talked about, are available to

all States for programs that emphasize abstinence, and these nine

States are supplementing that effort.

State policies incorporate a range of strategies. At least 16 of the

36 States are running statewide programs, while 14 are funding

local initiatives and the rest of the States are combining both approaches. Eleven States are using funds to evaluate abstinence

education or teen pregnancy prevention or out-of-wedlock birth programs. We are seeing more investment here since experts from the

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field as we have heard today have indicated that past programs

have not always been subject to rigorous evaluation.

Nine States are using media campaigns as part of their teen

pregnancy prevention strategy, while an additional twenty used

media campaigns as part of their abstinence education strategy. In

fact, last summer during a Capitol Hill briefing on TANF, we featured a media spot that was developed for the State of Mississippi

by a media consultant who worked with teenagers in shaping the

message of that entire media campaign.

Ten States are providing pregnancy prevention programs with

technical assistance, including curriculum development, an additional fourteen specifically targeting this assistance to abstinence

education efforts. I would like to offer a few specific examples of

what we have heard so far.

Your home State, Connecticut, is using a combination of both

State and TANF funds to support 18 pregnancy prevention models

based on Dr. Michael Carrera’s model. He serves, in fact, as a consultant and he has a very interesting and dynamic approach that

follows kids with a range of supports and skill building services.

Maryland is targeting the prevention of second births to teen parents. The State is investing $1 million in the home visiting program and a father involvement program. The programs target teenagers who are expecting and are receiving TANF or come from families that have received TANF. The fatherhood program seeks to

improve the long term involvement of both parents. Maryland is

also using its abstinence funds in a media campaign as well as investing in after school youth development programs.

Louisiana has designed a pilot project that targets the New Orleans area. Ten contracts have been issued to community-based

groups. Components of these programs include youth development,

comprehensive health and family life education, parental involvement, mental health services and counseling and male involvement. The target populations there include 11- to 19-year-olds, teen

parents and parents of teenagers.

Pennsylvania is using its abstinence education dollars to develop

a 5-year initiative. The 5-year project, called abstinence education

and related services, is funding 28 projects that cover 35 counties.

The abstinence program includes mentoring, adult supervision and

counseling. Training programs in abstinence education for teens,

parents, peers and health professionals is also provided.

Michigan is funding 18 community coalitions to provide an abstinence message that is geared specifically to the local needs of that

particular community. The program places an emphasis on 9- to

14-year olds.

Florida is a State that has included an evaluation component.

Florida is evaluating five pilot projects that use different pregnancy

prevention strategies. These projects include family life and sexuality education, medical and mental health services, tutoring, job

and career service activities, mentoring and community service activities. Parents are encouraged to participate with their children.

The programs serves approximately 1,600 at risk middle school

teens. At the same time, Florida has funded 17 statewide abstinence education grants to a variety of community-based organizations.

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These are a few of the examples of current State approaches in

strategies. APHSA will be happy to provide the committee with our

full report to be issued in the coming weeks. We expect to see expanded investment of TANF funds, greater coordination between

departments and partnerships.

Thank you for the opportunity to testify today.

[The prepared statement follows:]

Statement of John Sciamanna, Senior Policy Associate, American Public

Human Services Association

Madam Chairman, Congressman Cardin, members of the Committee,

goodmorning. My name is John Sciamanna; I am a Senior Policy Associate atthe

American Public Human Services Association. I am here today to sharepreliminary

results of our survey of state efforts aimed at reducing non-marital births and in

particular, to prevent teenage pregnancy.

As you know, the reduction of teenage non-marital births are a key concern to

state health and human service directors throughout the country. They know that

prevention of teenage births will significantly reduce future dependence on public

assistance and poverty. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 placed a special emphasis on reducing non-marital births.

Since the enactment of the law, APHSA has placed an emphasis on this issue by

convening sessions to examine state strategies, promising programs and by encouraging states to use their TANF block grant funds for this purpose.

In March 1997, October 1998 and March 1999, together with the Population Resource Center, APHSA sponsored national meetings in Washington and the Southern part of the country to examine local programs. We invited local pregnancy prevention program managers to Washington to explain their approaches in their various cities.

In the past few years, the goal of state TANF programs has been on moving families from welfare to work, however, states are also focusing more attention on this

issue by expanding past health department efforts and initiating new TANF-funded

programs. It should be emphasized that reducing teen pregnancy is not confined just

to the TANF arena but it is a broader issue that spans income groups and must

be addressed by a comprehensive approach involving a cross-section of state and

local departments, programs and communities-based organizations.

APHSA believes it is fundamental to the success of welfare reform that we address not just the needs of adults on TANF but we must also build a strategy that

addresses the needs of their children and preventing an unintended pregnancy is

part of that strategy.

APHSA began a survey of states on their work in this area and at this point we

have received responses from forty-four states and three territories. I would like to

share with the Committee the preliminary findings of a soon-to-be-published report

that highlights the wide range of state initiatives underway.

Thirty-six are funding teen pregnancy or out-of-wedlock birth prevention programs with either federal TANF funds or state Maintenance-of-Effort funds. Nine

of these thirty-six states are using TANF funds specifically for ‘‘abstinence-only’’

education efforts while thirty-six states are funding their ’abstinence-only’’ programs

with Title V funds.

State policies incorporate a range of strategies including media campaigns, case

management services to prevent second births, teen support and education programs, after-school programs that include abstinence education, youth conferences,

family life and sexuality education, tutoring, job and career activities, medical and

mental health services and mentoring combined with community services activities

to mention a few of the policies.

Our survey information indicates that at least sixteen states of the thirty-six

states are running statewide programs while fourteen are funding local initiatives

and the rest are using both approaches.

Eleven states told us that they were using funds to develop and implement evaluation methods for statewide and local abstinence education or teen-pregnancy prevention or out-of-wedlock birth programs. We are seeing a greater investment in

evaluation of these programs since many experts from the field have indicated that

past programs and approaches have not always been subject to such research.

Nine states reported using media campaigns as part of their teen pregnancy prevention strategy while an additional 20 use media campaigns as part of their abstinence education strategy. I would add that last summer, during a Capitol Hill briefVerDate 20-JUL-2000 08:01 Sep 08, 2000 Jkt 060010 PO 00000 Frm 00114 Fmt 6602 Sfmt 6602 K:\HEARINGS\65696.TXT WAYS1 PsN: WAYS1
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ing on TANF, we featured some of the media spots developed for the state of Mississippi by a media consultant who worked with teenagers in shaping the message.

Ten states are providing local pregnancy-prevention programs with technical assistance including curriculum development. An additional fourteen states are specifically targeting this assistance to abstinence education efforts.

In an effort to coordinate these policies some states are establishing councils that

will bring all parties together in a planning process. At least two governors have

appointed councils and another state has a twenty-five-member committee created

by the state legislature.

I would like to take this opportunity to focus on a few examples of state efforts:

Georgia has 28 programs funded with $3.9 million of TANF funds, that are aimed

at reducing risk behavior and poor health outcomes. Included in the Georgia strategy are male involvement programs that promote responsible behavior, delayed fatherhood and abstinence. These programs encourage community involvement and

also target parental involvement.

Maryland is targeting the prevention of second births to teenage parents. The

state is investing $1 million in a home visiting program and father-involvement program. The programs targets teenagers who are expecting and are either receiving

TANF or come from families that have. The fatherhood component is an effort to

improve the long term involvement of both parents. The Maryland is also using its

abstinence funds in a media campaign as well as investing in after-school youth development programs.

The state of Illinois has invested over $9 million in TANF funds over two years

in a program called ‘‘REACH’’—Responsibility, Education, Achievement, Caring and

Hope. This effort targets 10 through 17 year-olds by creating structured programs

for out-of-school time. Local agencies are contracted to provide services in communities that have a high concentration of TANF families. Separately, the state has

contracted with 31 agencies in selected areas to focus on abstinence-only education.

Louisiana has designed a pilot project that targets the New Orleans area that has

the highest teen-birth rate in the state. Ten contracts have been issued to community-based groups. Some of the components include youth development, comprehensive health and family life education, parental involvement, mental health services

and counseling and male involvement. Target groups include 11 through 19 yearold students, teen parents and parents or other adult caretakers of teens.

Pennsylvania is using its abstinence education dollars to develop a five year initiative. The five-year project called, ‘‘Abstinence Education and Related Services’’ or

AERS is currently funding 28 projects that cover 35 counties. In addition to delivering an abstinence message, the program includes mentoring, adult supervision,

counseling and training programs in abstinence education for teens, parents, peers

and health professionals.

Similarly, Michigan is funding 18 community-coalitions that will provide an abstinence message that is geared to specific local needs. The program places an emphasis on 9- to 14-year-olds.

Florida is an example of a state that has included an evaluation component. The

state is evaluating five pilot projects on different teen pregnancy prevention strategies, including family life and sexuality education, medical and mental health services, tutoring, job and career activities, mentoring and community service activities.

Parents are encouraged to participate with their children. The programs serve approximately 1600 at-risk middle school teens. At the same time, Florida has funded

17 statewide abstinence education grants to a variety of community-based organizations.

There are many other efforts going on, Iowa provides long-term ten year grants

to communities for long term prevention strategies and programs, Oklahoma is expanding existing health department efforts to increase outreach, Arkansas has convened a statewide youth conference as a part of its strategy. Efforts are expanding

across the country.

These are just a few examples of current state approaches and strategies. APHSA

will be happy to provide the committee with our full report to be issued in the coming weeks.

We expect to see expanded investments of TANF funds, greater coordination between state and local departments and partnerships in the coming years. Thank you

for the opportunity to testify today.

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STATE TEEN PREGNANCY PREVENTION AND ABSTINENCE EDUCATION EFFORTS

BACKGROUND

One of the core purposes of the Personal Responsibility and Work Opportunity

Reconciliation Act of 1996 (P.L. 104–193) is to prevent and reduce the incidence of

out-of-wedlock pregnancies. States may therefore use federal Temporary Assistance

for Needy Families (TANF) and state maintenance-of-effort (MOE) funds for programs and services designed to achieve this goal. The welfare reform law also added

a new formula grant program to Title V of the Social Security Act for states to provide abstinence education, mentoring, counseling, and adult supervision to promote

abstinence from sexual activity, particularly among those groups identified as most

likely to bear children out of wedlock.

According to a recent survey conducted by the American Public Human Services

Association, states are using TANF and Title V resources for a variety of efforts to

reduce out-of-wedlock pregnancies, with a heavy emphasis on promoting abstinence

and reducing pregnancy among teens. Some states are incorporating strategies into

their TANF policies, such as targeted case management services, while others are

specifically funding prevention programs. State human service and health agencies

are working with other public and nonprofit agencies, community groups, health

providers, and others to develop and implement programs and activities to achieve

this goal.

SURVEY FINDINGS

The APHSA survey asked two questions of states:

• Can you describe how you designed TANF policy or used TANF funds to reduce

the out-of-wedlock birthrate or teen pregnancy?, and

• Can you give an example of how abstinence education funds have been used in

a strategy to reduce out-of-wedlock birthrates?

All 50 states, three territories, and the District of Columbia responded to the survey. According to responses, most states are using TANF and/or Title V funds for

both teen pregnancy/out-of-wedlock birth prevention programs and teen abstinence

education. Specifically:

• 46 states reported funding teen pregnancy/out-of-wedlock birth prevention programs with federal TANF or state MOE funds;

• 45 states reported using federal Title V abstinence education funds for abstinence programs;

• 12 states reported using TANF funds for abstinence education, or combining

TANF and Title V funds; and

• 11 states reported focusing solely on teen abstinence using TANF funds, Title

V funds, or both.

Range of Activities

States are using available federal and state resources for a variety of activities

to prevent teen pregnancy and out-of-wedlock births and to promote teen abstinence,

including:

• Media campaigns

• Intensive case management

• Family planning referrals

• Community-based education programs

• Youth conferences

• Parenting skills programs

• Father involvement programs

• After-school programs

• Curricula for self-esteem building, abstinence education, etc.

• Teen support and education programs • Family life and sexuality education

• Medical and mental health services

• Tutoring, job and career activities

• Mentoring and community service activities

• Family cap and short work-exemption period for TANF recipients

• Statutory rape education and awareness

• Parent/child centers

• Family focus group

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Statewide/Local Programs

• Of the states funding specific teen pregnancy prevention/out-of-wedlock birth

programs, 16 indicated that they are using funds to run statewide programs, 13

states indicated that they are supporting local programs, and 14 states indicated

that they are supporting both statewide and local efforts. (The total does not equal

46 because combined teen pregnancy/abstinence programs are listed under abstinence.)

Connecticut is using a combination of state and TANF funds to support eight teen

pregnancy programs. These programs attempt to address a range of services and

supports. Pennsylvania, as part of the governor’s ‘‘Project for Community Building,’’

is implementing a statewide, five-year plan to promote abstinence to adolescents.

Rhode Island coordinated a state strategy by bringing together the Departments of

Children, Youth and Families, Health, Education, and Human Services. The multifaceted effort has focused on ‘‘Positive Asset Development’’ in youths. The statewide

plan also includes a media campaign, a male-responsibility project, and the use of

male role models. Utah has used TANF funds for training staff engaged in case

management, teaching workers how to bring up family planning services and how

to use resource and referral techniques.

While these statewide approaches involve the participation of local parties, other

states have sent funds directly to the local level. Many times these funds are awarded by requests for proposals (RFP); some states award money by formula. Most of

Colorado’s 63 counties have some prevention efforts underway. Services include programs to develop parenting skills, father involvement, and family planning services.

Virginia has recognized 50 coalitions in more than 100 communities by distributing

$1 million in TANF funds. These coalitions were required to conduct local community meetings on out-of-wedlock births and submit a resolution to their local elected

body agreeing to make efforts to reduce the out-of-wedlock birthrates. The state has

also committed to pass along any federal bonus funds to the communities that reduce their rates the most. Wisconsin established criteria for abstinence-only education grants and funds were awarded to the 13 local programs that met those criteria. New York transferred $7 million in TANF funds to the Department of Health

to be targeted to programs of community health education and outreach and to community-based adolescent pregnancy prevention programs. The Oregon STARS (Students Today Aren’t Ready for Sex) program for high school and middle school students is a school-based curriculum available in most of the state’s schools. The program’s focus is to engage teens in a discussion on sexuality and parenthood. South

Carolina has set aside $10 million in TANF funds to be provided to each of the

state’s 46 counties over a three-year period. The programs to reduce out-of-wedlock

rates will be developed to reflect local community values. Louisiana has targeted the

New Orleans area due to its high out-of-wedlock birthrate. As part of the state’s

strategy it has awarded 10 contracts to develop school-and community-based

projects.

Abstinence-Only Approaches

• Of the states funding abstinence education, nine indicated that they are using

funds to run statewide programs, 18 states indicated that they are supporting local

programs, and 19 indicated that they are supporting both state and local efforts.

Arizona is using $2 million in TANF funds and combining these dollars with its

Title V funds into a single abstinence-only program. The program includes a media

campaign and evaluation component and a variety of abstinence curricula. Funds

are awarded to local groups. The District of Columbia’s Public Health Department

has developed a collaborative effort around the abstinence approach. The department is working with a number of groups including the Mayor’s Committee to Reduce Teen Pregnancy and Out-of-Wedlock Births and the Metropolitan Police Boys

and Girls Clubs. They are participating in the ‘‘I’m Worth the Wait’’ education curriculum. The District plans to involve 10 additional organizations and agencies in

the effort. Massachusetts has developed the ‘‘Abstinence Education Media Campaign.’’ A series of television and radio ads were developed and aired with a target

audience of 9- to 14-year-olds. The ads also target parents of teens. The state is

building on that effort by adding a parent education film, facilitator’s guide, and

youth and parent brochures and posters. A number of planned community events

and messages educate youths about the relationship of alcohol and other substances

to sexual assault and the ability to remain abstinent. Michigan is using its funds

to assist 18 community coalitions that have developed and implemented communityspecific education, outreach, and awareness activities targeted to 9- to 14-year-olds.

Maine has developed a media campaign targeted to parents of teens in an effort to

increase parent-teen communication. The media campaign is reinforced with information packets to parents providing tips on how to talk to their children about sex.

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Media Campaigns

• 12 states reported that they are using media campaigns as part of their teen

pregnancy/out-of-wedlock birth prevention efforts and 26 states reported that they

are using media campaigns as part of their abstinence education programs. (Many

of these states used Title V funding, but four states reported that they combined

TANF and Title V Funds for a campaign.)

States have increasingly turned to the media in their efforts to reach ‘‘Generation

Y.’’ These campaigns are usually part of a larger strategy and are intended as an

ongoing effort. In a recent study, Delaware found that more than 68 percent of its

residents have seen the messages being conveyed by its media campaign on abstinence. The Delaware campaign uses radio, billboards, print media, and bus tags

with an emphasis on getting parents to communicate with their children about abstinence. Mississippi joined forces with a local marketing research firm that provided pro bono services. The collaboration resulted in a multimedia ‘‘Just Wait’’

campaign that includes a 16-minute documentary called ‘‘Heat of the Moment.’’ The

documentary offers advice from teens to teens about the results of teen pregnancy.

Wyoming has combined the use of TANF and Title V funds in an abstinence campaign. Wyoming has targeted 9- to 14-year-olds with a radio and television campaign. The message’s secondary target is parents and older siblings. A toll-free telephone number is also part of the strategy.

Appointed Councils

• Two states reported that they have councils or committees appointed by the

governor specifically to develop teen pregnancy/out-of-wedlock birth reduction and/

or abstinence programs.

The governor of Arkansas appointed a 10-member steering committee and hired

an abstinence coordinator to develop a strategy. One result of this effort was two

statewide conferences in November 1997 and May 1999. A 25-member legislatively

appointed committee also was created to assist in the development of a pregnancyprevention strategy. In Idaho the governor has created a 15-member council on Adolescent Pregnancy Prevention, comprised of members of key state departments, private business, health care professionals, and adolescents. The council has three subcommittees targeted to infrastructure, educational resources, and media strategy.

Evaluation Efforts

• 13 states indicated that they are using funds to develop and implement evaluation methods for statewide and local abstinence and/or teen pregnancy prevention/

out-of-wedlock birth programs.

Florida is funding five pilot projects on teen pregnancy prevention strategies and

at the same time evaluating the different approaches. Built into Iowa’s abstinence

education grant program is an evaluation of its four school-based curricula. Rhode

Island has built an evaluation component into its Male Responsibility Project. The

program aims to prevent ‘‘too-early’’ fatherhood and the projects will be evaluated

on their capacity to achieve specific outcomes such as increased abstinence, increased condom use, increased school attendance and improved grades, and improved access to medical care. A decrease in negative risk-taking behaviors and

other measures are also part of the evaluation process.

Family Planning Services

• 15 states reported that they are including family planning and sex education

in their teen pregnancy/out-of-wedlock birth prevention programs.

California has used TANF funds for a Family Planning Information Project for

TANF recipients. The goal of the project is to educate all audiences about the availability of free and low-cost services. An advertising campaign that also reaches the

general population is part of this effort. Alaska has targeted areas with high teen

pregnancy birthrates and high numbers of unintended pregnancies. The services include a fee system that enables women with incomes lower than 200 percent of poverty, who are not receiving Medicaid and have no other source of insurance, to receive these services at no cost. As part of a major coordinated effort between the

Department of Health and the Department of Human Services, Ohio has allocated

$250,000 of TANF funds for family planning services targeted to the prevention of

out-of-wedlock births. Kentucky has transferred funds into Title XX, the Social Services Block Grant, to provide family planning and a range of other prevention services.

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Males and Teen Fathers

• Four states have targeted males or teen fathers for special services or prevention efforts.

Georgia has funded 28 statewide comprehensive programs funded from $3.9 million in TANF funds. These programs include some that target the male population.

These programs for males promote responsible behavior, responsible fatherhood, and

abstinence. Indiana uses a combination of federal and state TANF funds for a local

grant program, the ‘‘Restoring Fatherhood’’ initiative. Maryland has invested approximately $1 million over three years to serve 150 families through the ‘‘Responsible Choice Home Visiting/Father-Involvement Program.’’

Case Management for Target Populations

• 24 states reported that they are including case management of TANF recipients

or high-risk teens in their teen pregnancy/out-of-wedlock birth prevention programs.

As part of its case management services, Vermont provides information about the

financial and emotional impacts of teen pregnancy and parenting. Ohio’s Learning

Earning and Parenting (LEAP) program is a case management program that predates welfare reform. LEAP targets teen mothers with a goal of keeping them in

school and preventing a second birth. Missouri’s Teen Education Attainment Model

(TEAM) is a school-based case management program that targets high-risk teens

with special support services to assist them in obtaining a diploma.

SPECIFIC STATE PROGRAMS

For each state, the initiatives listed under the heading ‘‘Teen Pregnancy Prevention’’ or ‘‘Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction’’ describe the

use of TANF funds, while the initiatives listed under ‘‘Abstinence Education’’ describe the use of Title V funds. Where TANF funds are used for abstinence education or TANF and Title V funds are combined, the initiatives are listed under the

heading ‘‘Teen Pregnancy Prevention/Abstinence Education.’’ If a state is not currently using TANF or abstinence education funds, no heading or initiatives are listed. This does not indicate that prevention efforts are not taking place but that the

state is using other departments or funds (such as public health) to pursue prevention strategies.

Alabama

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Alabama’s TANF

program provides family planning information and referrals to applicants and recipients of its Family Assistance and JOBS programs. Eligibility is not dependent

on acceptance or use of family planning.

Abstinence Education. Abstinence funds are being used for a media campaign and

to support local projects selected and evaluated by a state advisory committee.

Alaska

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Unintended

Pregnancy Prevention Initiative is a strategy to reduce unintended births to low-income, unmarried women through an extensive outreach and education campaign.

Family planning clinical services target areas with high birthrates, high numbers

of teen births and births to unmarried women, high numbers of unintended births

to all ages, and births to teens and women on Medicaid. The family planning services include development of a capitated fee system that enables women whose incomes are at or below 200 percent of poverty, and who are not receiving Medicaid

and have no other insurance available for family planning services, to receive these

service at no cost. In addition, the Statutory Rape Education Program is being designed to work with employers and government entities to provide education on the

problem of statutory rape. A media campaign of statewide television and radio

broadcasts will begin in July 1999, focusing on parent-child communication about

sex, males and statutory rape, males and child support enforcement, contraception,

teens and HIV, and the importance of teen pregnancy prevention and general

awareness. Abstinence Education. All abstinence education funds are given to local communities as grants for various abstinence programs and initiatives.

Arizona

Teen Pregnancy Prevention/Abstinence Education. Arizona is using $2 million in

TANF funds combined with Title V abstinence funds for a single program. These

funds are used to support a media campaign and to support and evaluate community-based service programs targeting youths, their parents, and adults who work

with youths. The message in the education and media components is ‘‘abstinence

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until marriage.’’ Grantees are using a variety of abstinence curricula and the media

campaign consists of three television spots, two radio spots, two brochures, and a

web site.

Arkansas

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Arkansas established

a 25-member legislatively appointed committee to develop teen pregnancy prevention programs and hire a program coordinator. Arkansas has formed a 15-county coalition to identify and implement strategies to reduce out-of-wedlock births. TANF

funds were used to hire a technical assistance/evaluation provider to assist the

counties with their projects. The state also held a statewide youth conference on

Unwed Teen Pregnancy Prevention in December 1998, and began a new media campaign in February 1999. The campaign featured locally developed spots with 10 television and 40 radio stations. Three grantee training sessions were also sponsored

to assist in developing strategies for youth conferences, coalition building, and other

activities.

Abstinence Education. The governor of Arkansas has appointed a 10-member

steering committee and hired an abstinence education coordinator. Arkansas used

federal funds to hold statewide conferences on abstinence education in November

1997 and May 1999, and awarded 16 education grants from March through December 1998. The state expects to award 19 grants in 1999. A statewide media campaign on abstinence education was initiated in February 1999.

California

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. California has used

TANF funds for a Family Planning Information Project for welfare recipients. The

goal of the project is to educate all audiences about the availability of free and lowcost family planning services. Information is distributed at county welfare offices

and through general population advertising campaigns.

Colorado

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Colorado is a countyadministered state; therefore it has no single statewide teen pregnancy prevention

program. However, most of its 63 counties are investing TANF or state and county

MOE funds in a variety of services designed to improve parenting skills, promote

father involvement, promote child development, and prevent teen pregnancies.

Teen Pregnancy Prevention/Abstinence Education. Colorado counties are also

using TANF funds for a variety of abstinence education efforts. For example,

Larimer County has budgeted $29,000 to help address the problem of unwed pregnancies by providing financial assistance for family planning supplies and increasing outreach to women in low-paying jobs to improve awareness of family planning

options.

Connecticut

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Connecticut Department of Social Services is using a combination of both state and TANF funds

to support eight teen pregnancy prevention programs throughout the state. These

programs follow a model designed by Dr. Michael Carrera, who serves as a consultant and technical advisor on teen pregnancy prevention. These programs are dedicated solely to primary prevention of teen births (first-time births). The Carrera

model involves comprehensive, long-term, intensive programming for adolescent and

pre-adolescent girls and boys. It emphasizes education, providing academic support

to help youths succeed and stay in school; career preparation, including work experience and community service; family life and sexuality education; and recreation.

Delaware

Teen Pregnancy Prevention/Abstinence Education. Delaware has continued its

media campaign, using billboards, print, radio, and bus tags advocating abstinence

and increased parental communication with their children regarding sexuality. A recent study reported that more than 68 percent of all Delaware residents have seen

the messages. Funding has also gone to community groups in targeted communities

and for mini-grants to promote abstinence through a variety of after-school and parent-child retreat activities. Efforts to reduce out-of-wedlock births have included

statewide conferences with recognized speakers, bringing together leaders of community-based organizations to address this issue. Planning is underway to develop

a comprehensive youth development program in the state’s urban areas with high

rates of teen pregnancy. This project plans to pool resources from all major funding

streams, including TANF, Title V, Title X, state funds, etc.

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The District of Columbia

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The District of Columbia is using TANF funds to provide assessment and ongoing case management

for teen parents and their children. Pilot projects will engage youths in after-school

programs, promoting academic and personal development, and encourage parental

involvement in the lives of their adolescent children.

Abstinence Education. The DC Department of Public Health’s Abstinence Education Project has developed an ongoing collaborative partnership with other youth

service agencies. The Department of Recreation’s Youth Intervention Division,

Planned Parenthood, DHS, the Mayor’s Committee to Reduce Teen Pregnancy and

Out of Wedlock Births, and the Metropolitan Police Boys and Girls Club participate

in training to teach the ‘‘I’m Worth the Wait’’ abstinence education curriculum to

the youths in their programs. The District plans to link an additional 10 agencies

and organizations to this program. Over a four-month period, the Abstinence Education Project has also provided 360 DC public school students with abstinence education and information through classroom education sessions.

Florida

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Florida is evaluating

five pilot projects on teen pregnancy prevention. These projects are holistic models

that provide a comprehensive range of services designed to give youths a ‘‘vision of

a future.’’ Program components include family life and sexuality education, medical

and mental health services, tutoring, job and career activities, mentoring, and community service activities. Each program includes instruction and emphasis on the

value of abstinence. Parents of at-risk teens are encouraged to participate with their

children. The programs serve about 1,600 at-risk middle school teens.

Abstinence Education. The Department of Health has awarded 17 state-wide abstinence education grants to community-based organizations, religious institutions,

and public health agencies for classroom instruction, after-school activities, enhancing self-esteem, goal setting, decision making, negotiation/refusal skills, counseling,

life skills training, peer education/mentoring, and parent education. Florida has also

funded a statewide media campaign targeting 9- to 14-year-olds, their parents, and

the community, to encourage abstinence and reduce the out-of-wedlock birthrate.

Georgia

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Georgia’s Adolescent

Health and Youth Development program has 28 statewide comprehensive programs

funded from TANF funds totaling $3.9 million. Programs are aimed at reducing risk

behavior and poor health outcomes. Male involvement programs are aimed at promoting responsible behavior, fatherhood, and abstinence; community involvement as

the mechanism for the direct involvement of parents, youths, and others in promoting positive youth development; and outreach activities designed to create

awareness and access among hard-to-reach youths and their families. TANF recipients are also required to sign a Personal Responsibility Plan for themselves and

members of their households. Policy requires that all children in the household age

13 and older attend family planning counseling that includes a wide pregnancy prevention messages.

Abstinence Education. Georgia receives $1.5 million in federal funds for abstinence education activities and uses a variety of strategies, including a media campaign designed to motivate youths to abstain from sexual activity until marriage

and encourage parent-child discussion on appropriate and expected sexual behavior

and distribution of competitive grant awards to youth-serving community organizations. More than 50 community-based organizations have been funded to initiate or

expand abstinence education efforts, including mentoring, academic tutoring, recreational activities, character and values clarification, relationship building, decision

making, and refusal skills.

Guam

Abstinence Education. The Department of Public Health and Social Services administers the Abstinence Only Education (AOE) program, funded by abstinence education funds. In FY 1999, funds were used to conduct a ‘‘Train the Trainers’’ seminar on the AOE project to educate program providers about strategies for teaching

adolescents and young adults, developing curriculum, and conducting pre-and postevaluations. The AOE program coordinator is working with program trainers to

begin the Partnership for Abstinence Only to address the reduction of out-of-wedlock

birth rates. The AOE program coordinator also collaborates with the health educator

to distribute brochures, pamphlets, and posters at mini-health fairs and conduct

educational sessions at various public schools.

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Idaho

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Idaho is using TANF

funds to support the Governor’s Council on Adolescent Pregnancy Prevention. The

council is composed of 15 members from public health, education, and welfare agencies, private business, adolescents, health care providers, local officials, media, clergy, and parents. The council includes three committees focusing on community infrastructure, educational resources, and mass media campaigns. The council intends

to support local coalitions through guidance and resource materials, training workshops, and assistance in organizing community awareness efforts. A statewide

media campaign is focusing on various messages, from encouraging parent-adolescent discussions to creating positive peer pressure, to relating the legal obligations

associated with parenthood, as well as lifestyle changes. The slogan for the campaign is: ‘‘Sex lasts a moment, being a parent lasts your whole life.’’

Abstinence Education. Abstinence funds support the development of community

coalitions that work with the Governor’s Council on Adolescent Pregnancy Prevention to raise awareness of the impact of adolescent pregnancy.

Illinois

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Illinois is using $4.4

million and $5 million in TANF funds in state FYs 1999 and 2000, respectively, to

support the Teen REACH (Responsibility, Education, Achievement, Caring, and

Hope) program. The program seeks to provide structured activities during out-ofschool time to expand the range of choices and opportunities that enable, empower,

and encourage youths age 10 to 17 to achieve positive growth and development, improve expectations and capacities for future success, and avoid and/or reduce risktaking behaviors such as substance use, criminal involvement, violence, and sexual

activity. The program tries to improve participants’ academic achievement; provide

opportunities for demonstrating positive social skills, instructions, and relationships

through supervised sports, recreation, and other program activities; provide opportunities for demonstrating positive social behavior through adult and peer mentoring;

and encourage positive decision-making skills that discourage negative risk-taking

behaviors. An underlying goal is strengthening parental involvement in the lives of

participating youths. Out-of-school programs are provided by contracted agencies in

selected communities across the state.

Abstinence Education. For state FY 1999 the department contracted with 31 agencies in selected areas across the state to address the instances of births to unmarried women, especially teens. The goals of the Illinois Abstinence Only Education

program are to reduce the proportion of adolescents who have engaged in sexual

intercourse, incidence of sexually transmitted diseases among teens 15 to 19 years

old; fertility rate among teens 15 to 17 years old; pregnancy rate among teens 15

to 17 years old; and the number of teen parents receiving TANF in the state.

Indiana

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. TANF funds and

MOE expenditures provide part of Indiana’s family planning funding and Restoring

Fatherhood initiative funding. Both programs grant funds to local community programs to strengthen families and reduce the incidence of unplanned pregnancies.

Abstinence Education. Indiana’s abstinence education funds are used for the

Project RESPECT program which is run by its state Department of Health. Project

RESPECT is mainly a mass media and education program to discourage teen pregnancy. Because Indiana has two sources of funding for programs dealing with teen

pregnancy—federal abstinence education funds and state funds from a line item in

its health department budget—local communities can select which funds they prefer

to use. Federal funds support organizations that stress abstinence until marriage,

while state funds support organizations that stress abstinence throughout the teen

years (and teach family planning, contraception, etc.). Currently, 52 local youthserving organizations rely on federal funds, and 29 local organizations rely on state

funds.

Iowa

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Iowa has a nineyear-old Adolescent Pregnancy Prevention Program that uses $760,000 of TANF

funds and in state FY 2000 will support nine community groups that applied to

work on adolescent pregnancy prevention. The state also uses the money for a statewide media campaign, a statewide coalition grant, and a statewide evaluation grant

for the community groups. Iowa also uses TANF funds ($1.99 million) for family

planning services, available to teens based on income.

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Abstinence Education. The Department of Health uses this money for four schoolbased curriculum development grants, as well as for funding an evaluation of those

programs. A portion of that money was also given to maternal child health clinics

that competed for grants.

Kansas

Teen Pregnancy Prevention/Abstinence Education. Kansas requires the provision

of intensive case management services to teen parents who receive cash assistance.

In state FY 2000, $200,000 in TANF funding has been reserved to evaluate one teen

pregnancy case management project and one primary prevention abstinence program. Both programs are currently operating in the state. The remaining funds are

earmarked for transportation, child care, or other intervention strategies that may

lead to enhance program participation.

Abstinence Education. Kansas has developed an abstinence education program

with performance measures for the rate of teen pregnancy, the percentage of outof-wedlock births to teens, and the rate of teen births fathered by men age 20 and

older. The abstinence education grant is administered by the Department of Health

and Environment.

Kentucky

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Kentucky transferred

TANF funds to the Social Services Block Grant for a variety of activities, including

family planning counseling in local health departments ($.5 million in state FY 1999

and a projected $1 million in state FY 2000), and providing family planning information and pamphlets to local welfare offices.

Teen Pregnancy Prevention/Abstinence Education. Abstinence education funds

were used to help support a statewide television, radio, and poster campaign in

1998. Tagged ‘‘Get a Life First—Wait to Have Sex,’’ the campaign promoted sexual

abstinence among teens. TANF funds are being used in 1999 to support a new campaign titled ‘‘If You Think You’re Ready for Sex, Are You Ready for This?’’ The campaign focuses on the consequences of sexual risk behaviors, and is also supported

in part by TANF funds.

Louisiana

Teen Pregnancy Prevention/Abstinence Education. The DSS has initiated a pilot

project to reduce teen pregnancy in the areas of New Orleans with the highest teen

birthrate. Ten contracts were awarded to create school-and community-based programs. Components of the project are youth development, comprehensive health/

family life education, parental involvement, mental health/counseling, and male involvement. Target groups are 11- to 19-year-old students, teen parents, and the

adult parents/caretakers of the teens. The agency has awarded a grant to the Louisiana Initiative for Teen Pregnancy Prevention for a statewide billboard campaign

to promote communication between parents and children regarding abstinence. The

billboards will be placed twice this year to coincide with the state and national teen

pregnancy prevention months. The agency is also in the process of requesting proposals for a statewide media campaign to provide education regarding teen pregnancy prevention and to develop an awareness of the effects of teen pregnancy on

the family and society.

Maine

Abstinence Education. Maine’s Abstinence Education Media Campaign has focused

on the need for parent-teen communication about sexuality. Through TV spots emphasizing the importance of such communication, and information packets for parents giving tips on how they can talk with their teens about sexuality issues, the

media campaign has sought to reduce teen pregnancies (most of which are to unmarried women). Maine also has an ‘‘Abstinence Works’’ presentation for middle

school students, ‘‘Positive Choices, Positive Futures’’ for parents of adolescents, and

three community grants to community action teams. The targeted age group is 9-

to 14-year-olds (and their parents), and an emphasis is placed on the cultural appropriateness of the messages.

Maryland

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Maryland Department of Human Resources (DHR) will invest approximately $1 million over

three years to serve 150 families through the Responsible Choice Home-Visiting/Father-Involvement Program. This program serves young adults who are expecting

their first child and are receiving and/or grew up in a family receiving cash assistance. The program aims to reduce subsequent non-marital births, increase the employment rate, and improve the long-term involvement of both parents in rearing

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their child. The program follows the Healthy Families America model for home-visiting services for prenatal and early infancy home visits. On-site services are also

offered including GED and employment training, job search assistance, and parenting classes. Biological fathers receive mediation counseling, paternity establishment assistance, and peer support groups in addition to the other services. Each

program site has a male involvement coordinator who oversees these services.

Abstinence Education. The Department of Health and Mental Hygiene uses abstinence education funds to help community organizations collaborate on state media

abstinence campaigns and offer after-school youth development programs with alternative activities. DHR sponsors the Best Friends program, a sub-initiative of the Responsible Choices Demonstration Project, which aims to prevent non-marital births

by promoting self-esteem, fitness, and community awareness to pre-teen girls. The

program will likely expand in the near future to make eligible all fourth-and fifthgrade girls at DHR-funded sites.

Massachusetts

Teen Pregnancy Prevention. Massachusetts has a continuum of programs and

services in place for women and adolescents to assure good pre-conceptual health

for women and to prevent teen pregnancies. Programs include a variety of health

services and health promotion programs, including community-based prevention activities to decrease teen pregnancy and other at-risk adolescent behaviors. The Challenge Fund: Teen Pregnancy Prevention Program provides funding to communities

with high teen pregnancy rates to develop a continuum of primary prevention services intended to increase abstinence, delay the onset of early sexual activity, and

reduce the rate of teen pregnancy and other related high-risk health behaviors

among adolescents.

Abstinence Education. Massachusetts funds abstinence-based pregnancy prevention through in-school programs that target middle-school youths. The goal is to

delay the onset of sexual activity in pre-adolescents and to increase the number of

youths who choose to remain abstinent through programs specifically designed to increase resiliency and academic skills. The Abstinence Education Media Campaign

was developed for abstinence-only programs through a federal grant under welfare

reform. The goal of the campaign is to increase the number of youths who choose

to remain abstinent. A series of television and radio ads was developed and aired

for pre-adolescent males and females ages 9 to 14, with clear messages that support

abstinence outside of marriage and the benefits of waiting. Messages encouraging

parents to communicate openly with their children about the importance of abstinence were also developed and aired. During 1999, a parent education film,

facilitator’s guide, and youth and parent brochures and posters will be completed.

In addition to a number of planned community events, messages that educate

youths about relationship of alcohol and other substances to sexual assault and the

ability to remain abstinent will be produced and aired. All messages are developed

with the input of youths, parents, and other local community members, and will be

available in both English and Spanish. A statewide advisory committee comprised

of parents, community members, and educational representatives oversees the entire campaign.

Michigan

Abstinence Education. Michigan is using abstinence education funds to support 18

community coalitions that have developed and implemented community-specific education, outreach, and awareness activities targeting 9- to 14-year-olds as well as

older teens. The activities aim to address the risks of sexual activity and associated

behavioral risks and influence decisions to delay sexual activity among teens. Funds

are also being used to develop media messages targeting teens and parents, and

support a broad-based state-level partnership of consumer, advocate, professional,

and laypersons to establish principles and practices guiding the use of resources.

Minnesota

Teen Pregnancy Prevention/Abstinence Education. The Minnesota TANF program,

Minnesota Family Investment Program, encourages personal responsibility and selfsufficiency. The Minnesota DHS works in partnership with the Department of

Health and its efforts in abstinence education.

Abstinence Education. Minnesota’s Education Now and Babies Later (MNENBL)

promotes abstinence education of adolescents ages 11 to 14 with the goal of preventing future unplanned pregnancies and dependence on assistance. The program

supports 14 grantees.

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Mississippi

Teen Pregnancy Prevention/Abstinence Education. Mississippi DHS joined forces

with a local marketing research advertising firm that worked pro bono to develop

a multimedia ‘‘Just Wait’’ abstinence campaign. The campaign included a 16-minute

unscripted documentary, ‘‘Heat of the Moment,’’ in which teens offer abstinence to

fellow teens as a real choice and solution to the problems of teen pregnancy and

sexually transmitted diseases. The documentary and a set of posters extracted from

it have been distributed statewide to schools, libraries, churches, and other youthserving organizations. Organizations from 22 states have used copies of the documentary. The campaign also incorporated two public awareness campaigns (one targeting parents and one targeting teens) that used radio and television public service

announcements plus purchased spots, print ads, and billboards. The ‘‘Just Wait’’ abstinence unit provides further abstinence-only materials and presentations upon request. The state legislature passed a bill at the recommendation of the Mississippi

Task Force on Reducing Out-of-Wedlock Pregnancies which states that abstinence

education shall be the state standard for any sex-related education course in the

state’s public schools. The task force also sponsored the first statewide Abstinence

Works! Let’s Talk About It! Conference on May 4, 1999, which was cosponsored by

DHS, the Department of Education, Department of Health, Mississippi State University Extension Service, and Mississippi Family Council.

Abstinence Education. Abstinence education funds, administered through the state

Department of Health, have been used to support community organizations that

teach children ages 10 to 19 the rewards of remaining abstinent until marriage. The

programs teach children the concepts of self-esteem, self-discipline, and self-respect.

Several programs have held award ceremonies to reward those children who have

pledged to remain abstinent until marriage.

Missouri

Teen Pregnancy Prevention. Missouri uses TANF funds to support the Teen Education Attainment Model (TEAM) program. TEAM is a case management program

based in local school districts to assist at-risk teens in obtaining their high school

diploma. The TEAM program provides supportive services to teens in the form of

transportation reimbursement, child care, training-related expense reimbursements,

and case management services. TEAM focuses its priorities on parenting or pregnant teens as well as those at risk of dropping out of school, and encourages teens

to stay in school through providing the program services.

Montana

Teen Pregnancy Prevention. A partnership project titled ‘‘Communicating with

Participants: An Introduction to Planning A Family’’ was initiated by the Women’s

Health Service (WHS) to join efforts with the Public Assistance Bureau (PAB) of the

Department of Public Health and Human Services to reduce unintended pregnancy

in Montana. A trainer with extensive experience with the Montana Family Planning

network and state teen pregnancy prevention was hired to develop the curriculum

and be the lead trainer. The WHS was able to leverage a $24,000 special initiative

Title X partnership grant to obtain an additional $50,000 from TANF funds for this

project. This partnership created a training system for organizations to foster lowincome families’ abilities to make informed decisions about planning a family. In addition, the established curriculum will be used to develop other statewide partnerships to promote family planning referrals from agencies that deal with low-income

clients at risk for an unintended pregnancy and in need of public assistance. Subsequently, family planning trainers could train other personnel, such as public health

home-visiting nurses.

Abstinence Education. The Title V abstinence education funds have not specifically been used to reduce out-of-wedlock birthrates. Rather, $60,000 was granted to

five communities around the state to address the need for parenting education programs. These parent-based programs will focus on ‘‘abstinence until marriage’’ for

the targeted youth population.

Nebraska

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Nebraska has two

specific initiatives in its Aid to Dependent Children (ADC) program that are designed to reduce out-of-wedlock pregnancies. The first is a family cap that does not

permit the normal increase in an ADC grant when a child is born 10 months after

the applicant or client is informed of this policy. In addition, the state only permits

a 90-day exemption from the employment requirements of the Employment First

program for those who expand their family.

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Abstinence Education. Abstinence education funds have been used for a public

education campaign with the theme ‘‘Friends First, Friends Forever’’ (based on

input from a state Youth Forum). The state also awarded funds, curricula, training,

and technical assistance to six communities with the highest levels of teen births

in 1997 to develop community-specific strategies promoting abstinence until marriage. Each community was offered a choice of curricula as well as technical assistance. The state has developed an evaluation component to measure the effectiveness

of these programs.

Nevada

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Nevada Welfare

Division has contracted with the University of Nevada to develop a two-hour training curriculum, manual, and compressed video designed to reach state and local law

enforcement officials, the education system, and relevant counseling systems that

provide education and training on the problems of statutory rape. Teenage pregnancy prevention programs may be expanded to include men. The Welfare Division

has reviewed the final TANF regulations and will be holding a Request for Information to obtain community interest in Teen Pregnancy Prevention Programs.

New Hampshire

Teen Pregnancy Prevention. TANF funds have been used to fund three home visiting projects serving pregnant women under 25 and their children (up to 2 years

old). Many teen mothers are served and one goal is to reduce subsequent pregnancies among that population.

Abstinence Education. New Hampshire will use abstinence funds to conduct a

media campaign geared toward young adolescents, stressing abstinence and pregnancy prevention.

New Jersey

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. New Jersey has established a Work First New Jersey (WFNJ) Inter-Departmental Adolescent Pregnancy Prevention Work Group that promotes collaboration across various state departments and oversees a statewide hotline and two mentoring programs funded by

TANF, collectively known as the Adolescent Pregnancy Prevention Initiative (APPI).

WFNJ hosted the inaugural Adolescent Pregnancy Prevention Month statewide

planning meeting involving more than 200 stakeholders from across the state. The

session provided ‘‘how to’’ information for planning local adolescent pregnancy prevention month events. WFNJ also hosted a Statewide Adolescent Pregnancy Prevention Month Pep Rally to raise awareness of the adolescent pregnancy prevention efforts in New Jersey. In total, $1.1 million in TANF funds is devoted to adolescent

pregnancy prevention efforts. The School-Based Youth Services Program (SBYSP)

operates in 30 urban, rural, and suburban school districts, to provide teens with a

comprehensive set of services in health care, mental health and family counseling,

job and employment training, and substance abuse counseling. Many SBYSPs also

offer on-site child care, enabling teen parents to remain in school, attend parenting

classes, and prevent subsequent pregnancies. The Pinelands SBYSP has been successful in reducing pregnancies from an average of 20 per year (prior to program

implementation) to an average of 1–3 pregnancies per year, for the last eight years.

TANF teen pregnancy prevention funds are also allocated to a hotline which takes

calls 24 hours per day and focuses on teen issues (specifically teen pregnancy prevention). This hotline is promoted through posters, wallet-size cards for youths, and

a public service announcement (PSA) that has been distributed to radio and television stations. The PSA is also being distributed to local movie theaters.

Abstinence Education. The New Jersey Department of Health and Senior Services

(DHSS) oversees the abstinence education projects, which are designed to teach preteens and teens the benefits of abstinence. During July 1998, DHSS awarded grant

funds for projects to develop or expand youth groups and train peer educators; develop or expand community-based education efforts on the benefits of abstinence, refusal skills, communication, and decision-making skills targeting at-risk youths;

local or regional mentoring programs; and parenting skills training including communications skill building and education on sexuality and the benefits of delaying

sexual activity for youths.

New Mexico

Abstinence Education. New Mexico has focused its efforts on young children (elementary and middle school age) in an effort to build social assets according to Peter

Benson’s positive choices curriculum. This is a form of primary prevention which

combats not only out-of-wedlock births but also other high-risk behaviors like drug

use and gang membership. New Mexico has also designed after-school programs,

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and has trained health educators in local health offices to teach abstinence in school

and parent settings. The state also has a marketing program, the cost of which is

split between Medicaid and Title V. It publishes a free teen magazine, ‘‘Not Yet:

Wait to Have Sex, Wait to Have a Baby,’’ which is designed to be fun for adolescents. The marketing program also makes t-shirts, baseball caps, and pins and has

developed multiple videos linking teen pregnancy and other high-risk behaviors. A

recent New Mexico responsible sexuality segment won an Emmy Award.

New York

Teen Pregnancy Prevention/Abstinence Education. In state FYs 1997–1998, New

York transferred $7 million in TANF funds to the Department of Health to target

programs of community health education and outreach and community-based adolescent pregnancy prevention to prevent unintended pregnancy in adults and adolescents eligible for TANF assistance. The funds were used to significantly expand the

Department’s Community-Based Adolescent Pregnancy Prevention Program

(CBAPP) and the Comprehensive Family Planning and Reproductive Health Program. CBAPP works with communities, providing information and education, promoting abstinence, expanding educational and recreational opportunities for teens,

and providing access to comprehensive reproductive health care services to sexually

active teens. Funding was also provided to 65 family planning agencies with more

than 230 service sites.

Abstinence Education. The Department of Health has purchased the Not Me, Not

Now media campaign developed in Monroe County. The campaign runs from fall

1998 to fall 1999 and features television, radio, billboard, and bus ads. The department also began a community-based component with approximately $5.6 million in

federal and state matching funds. This program will provide community information, abstinence education, outreach to high-risk youths, and services to young

males.

North Carolina

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. North Carolina is

conducting a statewide media campaign and training initiative with the message:

‘‘Parents, talk to your children about sex.’’ The state is funding training events and

programs for professionals who work with children, as well as supporting the development of an evaluation system for teen provider programs. Other efforts include

supporting adolescent parenting and prevention programs and local coalition programs. For state FY 1999, $2 million of the TANF block grant was targeted to these

programs.

North Dakota

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. North Dakota requires parenting skills training for adult recipients of its cash assistance program

when deemed appropriate, and provides education programs for dependent children.

The state aims to address the immediate problem with teens and to work on the

long-term effort to break the welfare cycle.

Abstinence Education. Funds are granted to local government and public entities

for a wide range of abstinence education including media campaigns and health education programs in local schools.

Ohio

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Ohio Wellness

Block Grant is a statewide initiative, with each of the state’s 88 counties receiving

funding to reduce teen pregnancy. The target population is youths between the ages

of 10 and 19. Each local Family and Children First (FCF) council has identified specific subpopulations within this age range for services. The Department of Youth

Services receives an allocation as Ohio’s 89th county due to the high rate of teen

pregnancy in its incarcerated population. Local FCF councils have responsibility for

planning, priority setting, selecting prevention strategies, allocating resources, monitoring programs, and tracking results. Program activities include mentoring programs, asset building, peer support programs, resource libraries, teen help hotlines,

teen parenting programs, media campaigns, and home visitation services. Local

councils report that awareness about teen pregnancy among public agencies and

local service providers has substantially increased, that many nonprofit agencies are

working more collaboratively, and that schools are becoming more connected to social service organizations. The Ohio Learning, Earning and Parenting (LEAP) program is a statewide initiative, designed to help teen parents complete high school

and reduce the incidence of second pregnancies. The LEAP program combines support services with case management, and incentives for school attendance, grade

completion, and graduation, with penalties for non-attendance. The LEAP program

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affects about 8,000 teen parents each year. In the last three years, Ohio has combined efforts with Early Start (a home visiting program) to provide additional services to teen parents to assist with pregnancy prevention and care of young children.

In the fiscal year beginning July 1999, the Ohio General Assembly created the Ohio

TANF Family Planning Program. It will provide $250,000 of TANF funds for prepregnancy family planning services designed to prevent out-of-wedlock births. This

is a joint effort between the Ohio Department of Health and the Ohio Department

of Human Services.

Abstinence Education. The Ohio Department of Health administers the abstinence

education program and provides funding to 34 (in state FY 1999) agencies to conduct programming in school settings. Funded agencies include community-based and

youth-serving organizations that have not traditionally received funds from the department; local health departments; local school districts; hospitals; an FCF council;

a county department of human services; and a prosecuting attorney’’s office. Program activities include age-appropriate curricula and presentations to teach abstinence from sexual activity and other associated risk behaviors for unmarried teens.

Social skill instructions, character-based education, asset building to promote selfesteem, as well as parent education, are other program approaches that agencies

use in reaching youths.

Oklahoma

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Family Support

Services collaborated with the Health Department to expand and develop already

existing teen pregnancy outreach programs. The new program hires TANF recipients as outreach workers who target high-risk teens and families. This is currently

a pilot program in a few counties. TANF dollars also help to fund programs that

specifically target first-time mothers, hoping to reduce the chance of a second birth.

Abstinence Education. Oklahoma installed an abstinence curriculum in high

schools in six counties. Each county can choose its own curriculum, but the most

popular is called Facing Reality. Four of the projects have finished their first year,

and about 1,000 teens have participated in the curriculum. Approximately 850 of

those were evaluated by the University of Oklahoma’s Institute for Public Affairs.

Oregon

Teen Pregnancy Prevention/Abstinence Education. The Oregon Adult and Family

Services (AFS) Division of the Department of Human Resources has worked with

and provided funds to local organizations to help offer pregnancy counseling to teens

and raise awareness of the risks and dangers of unwed parenthood. TANF funds

have been used for the Students Today Aren’t Ready for Sex (STARS) program.

STARS is an abstinence-based teen pregnancy prevention curriculum in which teen

leaders from high schools teach sixth-and seventh-graders how to identify and resist

pressures that lead young people into premature sexual involvement. The program

reached about 29,000 students during the 1998–1999 school year. The Reduce Adolescent Pregnancy Partnership (RAPP) is a network of local coalitions dedicated to

preventing teen pregnancy. The goal of RAPP coalitions is to solidify comprehensive

teen pregnancy efforts by both local and state partners by providing leadership, support, and assistance throughout the state to meet the Oregon benchmark with regards to reducing teen pregnancy. In addition to these community services, AFS

contracts with local partners (such as community colleges, etc.) to provide parenting

classes and counseling to teen parents. The partners provide information regarding

sexuality and subsequent pregnancy prevention as part of the classes and counseling. AFS case managers enter into discussions with teen parents as often as the

situation permits and encourage them to take steps to ensure against subsequent

pregnancies.

Pennsylvania

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Pennsylvania is focusing on the issue of teen pregnancies that result from relationships with older

men through a Statutory Rape Task Force and a contract with the Pennsylvania

Coalition Against Rape (PCAR). The state launched an ad campaign and educational

program to increase awareness of the statutory rape laws among middle school, junior high, and high school students and staff. The campaign features posters, a teen

magazine, a CD of songs about teens in various relationship situations, and free

concerts at underage dance clubs.

Abstinence Education. The Pennsylvania Department of Health, through the Abstinence Education and Related Services (AERS) Initiative, and as part of the Governor’s Project for Community Building, is implementing a five-year comprehensive

statewide plan to promote abstinence as a positive lifestyle decision for young adolescents. Currently 28 AERS community-based projects serve 35 counties. The

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projects will deliver abstinence-only education and related services to children and

adolescents throughout communities and schools. Services include mentoring, adult

supervision, counseling, and training programs for parents, peers, and health professions on how to conduct abstinence education. A statewide media campaign is also

planned to raise public awareness of the benefits of abstinence, the negative consequences of teen pregnancies outside marriage, and the central role of parents and

significant others as the prime educators of their youths.

Puerto Rico

Abstinence Education. Puerto Rico has developed the Puerto Rice Abstinence Education Program (PRAEP) to reduce teen pregnancy. Its philosophy is abstinence as

the only alternative that is 100 percent effective in reducing teen pregnancy and

sexually transmitted diseases. The program includes a ‘‘Sex Can Wait’’ curriculum

developed by the University of Arkansas which was implemented in public schools

from grades 5 to 12. The program will also include peer groups to promote sexual

abstinence using character development strategies. In total, PRAEP has reached

58,182 Puerto Rican adolescents. A mass communications media campaign was

being developed by students during a summer camp in June 1999, and coalitions

around the island including students, parents, teachers, health professionals, local

entrepreneurs, and others will develop customized socio-recreational activities for

their communities.

Rhode Island

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Rhode Island

Departments of Children, Youth and Families, Health, Education, and Human Services are collaborating on a comprehensive statewide plan to reduce the incidence of

teen pregnancy. The efforts focus on ‘‘Positive Asset Development’’ of youths, and

incorporate a holistic approach to youth development conveyed through strong, appropriate relationships with caring adults. The statewide plan supports statewide

and local efforts and includes media campaigns for teen pregnancy prevention, family planning, and sex education. The Department of Health is funding a monitoring

program. Rhode Island has also initiated the Male Responsibility Project through

the Department of Human Services. Services are provided by male counselors from

five community-based organizations that also serve pregnant and parenting adolescent girls. The program aims to prevent ‘‘too-early’’ fatherhood, and the individual

projects will be evaluated on their capacity to achieve specific outcomes such as an

increase in abstinence, increase in use of condoms, increase in school attendance

and grades, improved access to medical care, decrease in negative risk-taking behaviors, and other measures. The five projects will operate in 10 cities and towns including the five core cities with the highest rates of teen pregnancies. Others are

rural, suburban, and small town areas.

Abstinence Education. The Department of Health is using federal abstinence education funds for a program that provides training and support for male role models.

The project is being implemented in four areas with the highest teen pregnancy

rates in Rhode Island. The state also runs an after-school program for middle-school

adolescents, but is funding it with resources other than the federal abstinence education funds.

South Carolina

Teen Pregnancy Prevention. During the 1998 legislative session, the South Carolina General Assembly passed legislation that created the County Grants Fund for

Adolescent Pregnancy Prevention Initiatives. This was funded with $10.5 million of

TANF funds, intended to be distributed to each of South Carolina’s 46 counties over

a period of three years. The purpose of the fund is to support local efforts to prevent

early sexual activity and to measurably reduce the rate of adolescent pregnancy in

each county. Programs developed will reflect local and community values. Additionally, all initiatives funded will emphasize premarital sexual abstinence and male responsibility.

South Dakota

Abstinence Education. The South Dakota Department of Health gives subgrants

to communities to design their own abstinence projects. The department itself approves the projects and provides oversight.

Tennessee

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Tennessee gave

$300,000 in grants to 30 counties with the highest number of out-of-wedlock births.

All four large urban counties have teen pregnancy parenting/prevention programs

as do several rural counties as well. Strategies for these programs include mass

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media campaigns, focus groups, and others. Teen programs use individual and group

case management in and out of school with teen parents. The message of these programs is stay in school, be a good parent, plan a career, and prevent additional unplanned pregnancies.

Abstinence Education. The Tennessee Department of Health awarded grants to

local schools, nonprofit organizations, and community groups for abstinence education efforts.

Texas

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Texas has funded

four pilot projects that provide residential and non-residential services targeted to

teen parents that include counseling and parenting skills classes. Additionally,

Texas funds programs that provide prenatal intervention or at birth with high-risk

families. Teens identified at this point of intervention receive parent education,

training, and counseling services that encourage families to think about their ability

and desire to provide adequately for additional children, and actively link them to

family planning services. Some of these programs specifically target teen parents for

their service delivery to help reduce the number of additional teen pregnancies. The

Texas Workforce Commission, in collaboration with the Texas Department of

Human Services and the Texas Department of Protective and Regulatory Services,

is involved in a Second Chance pilot program to reduce and prevent the problems

teen parents and their children face and to break the cycle of welfare dependence.

The program will provide independent living services and licensed adult-supervised

living arrangements to teen parents and their children who receive TANF assistance. Under this program, a teen parent not living with a parent, legal guardian,

adult relative, or in a licensed adult-supervised living setting, and applying for

TANF, will be referred to the program provider. The provider will assess the needs

of the teen parent and either work with other agencies to ensure those needs are

met, or provide the needed services themselves.

Abstinence Education. Texas held an Abstinence Education Conference in July

1998 that was open to abstinence education contractors and to the general public.

It has funded 32 entities to provide abstinence education, with activities that include classroom instruction and/or assemblies; counseling; mentoring; after-school

activities like field trips, dances, resource library, computer dolls, retreats, community involvement, web sites, home liaisons, and a hotline; peers as teachers; and

media campaigns.

Utah

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Utah has used TANF

funds for six pregnancy prevention contracts across the state. It also uses the money

for statewide training for all staff engaged in case management, teaching them how

to bring up family planning with customers, and resource and referral techniques.

Abstinence Education. Utah has given abstinence education funds to 11 community-based projects in various parts of the state, targeting 9- to 14-year-old youths

(both boys and girls). The state views abstinence only as one part of a continuum

of pregnancy prevention education, particularly appropriate for that age group. The

projects take place in school, after school, and in private settings. Some curricula

are standard, such as ‘‘Sex Can Wait’’ and ‘‘Postponing Sexual Involvement.’’ Other

curricula are more unique to the locality.

Vermont

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. Vermont provides

TANF recipients with individualized case management that focuses on helping families reach goals they have set for themselves. Information about the financial and

emotional impacts of teen pregnancy and parenting with a partner is included. In

addition, TANF funds support a network of parent/child centers that include a focus

on preventing initial teen pregnancies and promoting stable families.

Abstinence Education. Funds were used to hold focus forums with families, design

and pilot test an abstinence promotion media campaign, and provide fulfillment materials in response to the PSA. The campaign targets families of middle-school and

young high-school students, stresses the connection of substance use and unintended sexual activity, and promotes the importance of parent-child communication.

The Virgin Islands

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. The Virgin Islands is

funding television and radio advertisements designed to prevent teen pregnancy and

enhance responsibility and accountability among teens. It provides social work services to TANF recipients and young mothers in an effort to prevent and reduce teen

pregnancy.

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Virginia

Teen Pregnancy Prevention. In 1997, Virginia offered TANF funds to coalitions

across the state who joined its ‘‘The Commonwealth and You: Partners in Prevention’’ initiative. Each coalition was required to conduct a local community meeting

on out-of-wedlock births and submit a resolution from its local elected body agreeing

to attempt to reduce out-of-wedlock birthrates in their communities. To highlight

the initiative, four regional forums on out-of-wedlock births were conducted by the

secretary of Health and Human Services and the commissioners of Health and Social Services. More than $1 million in TANF funds were then distributed to 50 coalitions in the more than 100 communities who positively responded. (Virginia has 134

recognized city and county communities.) These coalitions were promised that if Virginia was awarded one of the $20 million prizes that Congress offered to five states

with the best results, the funds would flow through to those communities who similarly showed the greatest decrease in out-of-wedlock births without a concomitant

increase in local abortion rates. A majority of the coalitions chose to focus on teen

pregnancy prevention, and were given broad leeway to design their own local, grassroots initiative to help to solve this difficult social problem. The Partners in Prevention (PIP) initiative did not operate in FY 1999, but will operate again in FY 2000,

with potential awards reduced to a maximum of $15,000 per coalition. The new PIP

guidelines will also require a focus on 20–30 year olds with an abstinence-only emphasis in the approved interventions. Those funds are scheduled to be awarded in

August. Despite the 13-month lull in support for the PIP coalitions, Virginia ranked

12th in its last review of comparative state out-of-wedlock rates. Virginia is now

working with local and state social service leaders to assess the potential use of excess TANF funds for preventive approaches to youth development and teen pregnancy prevention and is hopeful of assisting communities to replicate successful and

effectively evaluated models of youth development programs in several areas of Virginia with these funds.

Abstinence Education. When Virginia received the initial federal funds for abstinence education, the first year’s initiative involved a statewide media campaign to

reduce sexual activity before marriage. The ‘‘Not Me Not Now’’ media campaign

from Monroe County, New York, was secured through a contract with its founders.

Posters and television and radio spots were targeted during prime time when adolescents were expected to be tuned in. In the second year, six local community programs were funded through a competitive proposal process. An evaluation system

was established to measure the effects of the programs, since this type of intervention has not previously been tested with adequate sample sizes, control groups, or

satisfactory evaluative methodologies. The programs are primarily serving youths

between the ages of 13 and 17. The programs begin their second year of development in September.

Washington

Teen Pregnancy Prevention. The Workfirst program has designed flyers and posters focusing on birth control and family planning messages. Each community service

office provides family planning information and services. In most offices a family

planning worker and/or a public health nurse is stationed on site to provide pregnancy prevention services and information.

Abstinence Education. The Department of Health is currently receiving funds for

abstinence education. These funds have been used for seven community-based

projects around the state. These projects focus on abstinence and public education.

The Department of Health and the Office of Superintendent of Public Instruction

have an interagency agreement to provide the ‘‘Teen Aware’’ program that focuses

on abstinence and waiting until marriage.

West Virginia

Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction. West Virginia, using

Title V funds, supports a community-based initiative to educate, promote, and support communities in developing programs focusing on parent-child communication/

interaction; adolescent risk reduction behaviors such as alcohol and drug use, and

abstaining or postponing sexual intercourse. In addition, the state, in collaboration

with the Domestic Violence Coalition, developed and distributed a booklet that addresses statutory rape, and includes strategies for helping youths resist coercive sexual advances. Targeted efforts to reduce teen pregnancies include the availability of

contraceptive care at 133 community-based sites throughout the state; hiring an adolescent pregnancy prevention specialist to work alongside medical, social, educational, and community partners designing activities and programs that foster

youth resiliency; and discouraging early onset of sexual activity.

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Abstinence Education. West Virginia has contracted with community organizations for the teaching of abstinence-only curricula that adhere to federal statutory

requirements. Activities and oversight for the Abstinence-Only Initiative are directed with input from a statewide advisory body comprised of educators, parents,

faith-based organizations, and the health care community.

Wisconsin

Abstinence Education. Wisconsin has established the Wisconsin Abstinence Education Project (WAEP) which has funded 13 local abstinence-only education grants,

given to programs that meet certain criteria for promoting abstinence. WAEP is an

important part of Wisconsin’s new adolescent pregnancy prevention plan, Brighter

Futures, which proposes a comprehensive, community-based approach to pregnancy

prevention and provides recommendations and strategies for a variety of groups, including parents, educators, local officials, youths, faith-based organizations, and the

health care community.

Wyoming

Teen Pregnancy/Abstinence Education. TANF and abstinence education funds are

combined into an abstinence-only media campaign called Sex Can Wait Wyoming.

This TV and radio campaign is aimed primarily at 9 to 14 year olds and secondarily

at their parents, siblings, and community. It features a hotline that people can contact for more information. This media program is based on Michigan’s similar program. Wyoming is also operating an ongoing task force composed of state agencies,

abstinence-based nonprofits, family planning clinics, and family planning nonprofits.

Funding is primarily received from the TANF grant. The task force sponsors an annual pregnancy prevention conference that explores issues of unintended pregnancy.

The task force has also granted money to agencies wishing to expand pregnancy prevention services to teens. Future plans are for initiatives to address male involvement in the out-of-wedlock pregnancy issue.

State Contacts

State Department Name Phone

Alabama ........................ Human Resources ........ Jean Blackman ............. (334) 242–1978

Alaska ........................... Health and Social

Services.

Cheryl Adamson ........... (907) 465–3382

Arizona .......................... Economic Security ....... Ben Levine .................... (602) 542–0212

Arkansas ....................... Bureau of Public

Health.

Donnie Smith ................ (501) 661–2243

California ...................... Social Services ............. Chris Minnich ............... (916) 654–1074

Colorado ........................ Human Services ........... Maynard Chapman ....... (303) 866–2054

Connecticut ................... Social Services ............. Zena Kovack .................. (860) 424–5334

Delaware ....................... Public Health ............... Prue Kobasa .................. (302) 739–4785

Washington, DC ........... Public Health ............... Ellen M. Wells .............. (202) 727–5930

Florida ........................... Health ........................... Bridgett Rahim-Williams.(850) 922–1218

Georgia .......................... Adolescent Health ....... Ronnie S. Jenkins ......... (404) 657–2868

Guam ............................. Public Health ............... Lucy S. Cruz ................. (671) 735–7104

Hawaii ........................... Human Services ........... Patricia Murakami ....... (808) 586–5230

Idaho ............................. Health and Welfare ..... Galen Louis ................... (208) 334–5957

Illinois ........................... Family Health .............. Sue Haury ..................... (217) 782–2736

Indiana .......................... Health ........................... Judith Ganser ............... (317) 233–1240

Iowa ............................... Human Services ........... Jo Lerberg ..................... (515) 281–4207

Kansas .......................... Social and Rehabilitation Services.Connie Ulmer ................ (785) 296–2465

Kentucky ....................... Public Health ............... James S. Davis ............. (520) 564–4830

Louisiana ...................... Social Services ............. Elaine Fontenot ............ (225) 342–0485

Maine ............................ Human Services ........... Nancy Birkhimer .......... (207) 287–5361

Maryland ...................... Human Resources ........ Stacy L. Rodgers ........... (410) 767–7393

Massachusetts .............. Health and Human

Services.

Mary Osterman ............. (617) 727–7600

Michigan ....................... Community Health ...... Virginia Harmon ........... (517) 335–9371

Minnesota ..................... Human Services ........... Pam Reinstatler ............ (651) 296–9407

Mississippi .................... Human Services ........... Rebecca Doyle ............... (601) 359–4437

Missouri ........................ Health ........................... Becky Houf .................... (573) 751–9488

Montana ........................ Public Health and

Human Services.

Suzanne Nybo ............... (406) 444–3775

Nebraska ....................... Economic Assistance ... Dan Cillessen ................ (404) 471–9270

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State Contacts—Continued

State Department Name Phone

Nevada .......................... Human Resources ........ Vicki Kemp .................... (775) 687–4715

New Hampshire ........... Community and Public

Health.

Joan Ascheim ................ (603) 271–4516

New Jersey ................... Human Services ........... Edward Tetelman ......... (609) 292–1617

New Mexico .................. Human Services ........... Barbara Otto ................. (505) 841–2973

New York ...................... Health ........................... Barbara McTague ......... (518) 474–3368

North Carolina ............. Public Health and

Human Services.

Sydney Atkinson ........... (919) 733–7791

North Dakota ............... Human Services ........... Kevin Iverson ................ (701) 328–2332

Ohio ............................... Human Services ........... Joel Raab ....................... (614) 466–1822

Oklahoma ..................... Health ........................... Marilyn Lanphier ......... (405) 271–4471

Oregon ........................... Human Resources ........ Jeff Stell ........................ (503) 945–6737

Pennsylvania ................ Public Welfare ............. Gail Bean ...................... (717) 772–7829

Rhode Island ................. Children, Youth and

Families.

Pamela Goodwin ........... (401) 462–2423

South Carolina ............. Social Services ............. Carol Singletary ............ (803) 898–9376

South Dakota ................ Social Services ............. Donna Keeler ................ (605) 773–4678

Tennessee ..................... Human Services ........... Wanda Moore ................ (615) 313–4866

Texas ............................. Health ........................... Jack Baum .................... (512) 458–7700

Utah .............................. Workforce Services ...... Shannon Bond ............... (801) 468–0129

Vermont ........................ Human Services ........... Cheryl Mitchell ............. (802) 241–2244

Virginia ......................... Social Services ............. Forrest Mercer .............. (804) 692–1297

Virgin Islands ............... Human Services ........... Lennox Zamore ............. (340) 774–4673

Washington ................... Social and Health

Services.

Rachael Langen ............ (360) 413–3209

West Virginia ............... Health and Human

Services.

Pat Moss ........................ (304) 558–5388

Wisconsin ...................... Health and Family

Services.

Joe Leean ...................... (608) 266–7882

mony, all of you. It is very, very impressive to me that the flexiWyoming ....................... Health ........................... Phyllis Sherard ............. (307) 777–7942

Chairman JOHNSON of Connecticut. Thank you for your testif

bility under TANF and the generosity of the funding is allowing us

to begin to look at some of the causes of our problems rather than

just the effects. I hope you will all be part of, without exception,

standing up for a continued level funding of TANF because I think

we are just now getting to the payoff of flexibility in funding, and

if we don’t stick with it, we will never get to solve some of the problems like nonmarital births but also the difficult problems of substance dependence and mental—untreated mental health problems

and things like that.

In fact, I think some of these programs that are aimed at discouraging teenagers from getting into inappropriate relationships

will also get them into appropriate mental health relationships

that are very important. When I hear these kids talk about their

lives, honestly, the challenge to many of them is far greater than

most of us have ever faced.

So I think we do need to really fight for the TANF dollars to be

maintained because they—and it was very impressive, the number

and variety of State approaches that we see out there. It also is interesting that, Ms. Miller—let me see now, Ms. Maynard, the variety of things that you are evaluating and the different approaches.

So it will be useful to us to see both of your reports as they get

completed.

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In doing that oversight work, Ms. Maynard, is it difficult to determine whether or not programs are complying with the letter of

the abstinence law? You ran into this problem that we have talked

about in preceding panels of sort of gray area of being serious

about abstinence but also providing some information about contraceptives.

Ms. MAYNARD. We have gone about our work in a fairly strategic

way. We have done a lot of homework before we have gone to the

field, before we actually select our final set of sites for the evaluation. We are spending time in each site. We are actually observing

programs, reviewing materials, spending a lot of time with the program staff. So we will be evaluating programs that are totally consistent with the legislation. We have not found it very difficult to

determine what the messages in the programs are.

Chairman JOHNSON of Connecticut. Would you say—what percentage of these programs would you say do include some information ultimately about safe sex?

Ms. MAYNARD. Well, we have not surveyed all of the programs

so, we have, as I said, gone about our work in a strategic way. I

can say that most of the abstinence education programs that we

have observed do address at some level issues of contraception, but

they do not address them in a promotional way. They address them

in a factual, informational way. It is not a major piece of the intervention.

Chairman JOHNSON of Connecticut. Interesting. Would any of the

rest of you have any comment on that? Mr. Tetelman, from sort of

the practical point of your experience in New Jersey?

Mr. TETELMAN. Our programs always have balance in them. We

don’t have—the Department of Human Services isn’t running the

abstinence only grant in New Jersey. That is being done through

the Department of Health and Senior Services, but what we have

learned is that if you offer young people a balance and a connection

with an adult to say, first, ‘‘Look, the only safe way is not to have

sex at all but if you are going to have sex then you need to protect

yourself, you have to have knowledge about it, and come talk to

me’’. You know, most of the time when young people come talk to

an adult they learn how to make decisions because that is really

what they are looking for in many cases, how do I make a decision,

I am getting pressure, how do I actually come down to saying yes

or no or is this really what I want to do, and having that touch

by that adult, somebody they trust, we wish it were the parents

more than it is, but unfortunately, it is mostly staff in many of our

sites, makes a difference in young people obviously making the

right decision. Those statistics from the Pineline High School are

unbelievable.

Chairman JOHNSON of Connecticut. That was very impressive.

Mr. TETELMAN. And it has been consistent for over 8 years. It

really was a drop and we have received a Dodge grant to try to replicate it in some of our other sites, including our urban sites.

Chairman JOHNSON of Connecticut. In that instance, do you

know much about whether the level of sexual activity dropped? Did

it drop among the early groups but later on actually, in other

words, it might not have dropped among the early groups, the early

groups might have just used contraceptives, but the upcoming

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groups might actually have changed their behavior? Do you have

any——

Mr. TETELMAN. It is all anecdotal, but I have actually asked the

same question of staff, and they say it is a real mix, that some

young people just make a decision, they get their act together and

say I have other things I want to do with my life and I am not

going to engage in sex. And other ones say, ‘‘Well, if I am going

to engage, I am going to be responsible about those activities.’’ It

is really mixed. We don’t have clean lines on it, but I think it is

important to offer—you know, we can’t stick our heads in the sand

and think kids aren’t going to have sex. They have sex, and if they

are going to have sex, we need to have a balance here to make sure

that they get the right information and protect themselves so we

don’t have unwanted pregnancies.

Chairman JOHNSON of Connecticut. But certainly in those programs, too, what is happening is that kids are getting a lot of support to not have sex.

Mr. TETELMAN. Absolutely, and the important thing is having

that connection with adults and having activities for young people.

I mean, we can talk about lots of different things, but unless you

have programs that kids can be involved in, whether it is after

school or jobs or things that keep them from free time where they

can get in trouble, that makes the biggest difference.

Chairman JOHNSON of Connecticut. Anyone else have any comment you want to make before we close? Yes, Ms. Miller.

Ms. MILLER. I just want to say that one of the things we have

learned at the campaign is that the programs, as you say, are very

important, and they don’t have to be focused necessarily on pregnancy prevention or on sex ed or on abstinence or on contraception.

They have to include a consistent, caring adult, skill building or opportunities to excel, and they have to go on long enough to make

a difference in the lives of the young people.

Chairman JOHNSON of Connecticut. That certainly is what Pathways/Senderos has found in our area, that the whole issue really

is trust and consistency and being there and that the longer they

are, the more the issue of contraceptive knowledge is far from central. It is just an aside, but it does—the questions do come up partly because they need that information to counter their peers.

Thank you very much, all of you who have testified today. We

do appreciate your input, and I also think one of the wise things

about the Welfare Reform bill was that it did take some different

approaches that has enabled us to get this conversation out in the

open where our kids can benefit more from it, and hopefully, we

can benefit more from it, and as Ms. Ware said, stop sending quite

such contradictory messages to our own children. Thank you very

much.

[Whereupon, at 12:15 p.m., the hearing was adjourned.]

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